Decision making in health and medicine: Integrating evidence and values

M. G Myriam Hunink, Milton C. Weinstein, Eve Wittenberg, Michael F. Drummond, Joseph S. Pliskin, John B. Wong, John B. Wong, Paul P. Glasziou

Research output: Book/ReportScholarly editionResearchpeer-review

254 Citations (Scopus)


Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing the resources required. This text takes a proactive, systematic and rational approach to medical decision making. It covers decision trees, Bayesian revision, receiver operating characteristic curves, and cost-effectiveness analysis; as well as advanced topics such as Markov models, microsimulation, probabilistic sensitivity analysis and value of information analysis. It provides an essential resource for trainees and researchers involved in medical decision modelling, evidence-based medicine, clinical epidemiology, comparative effectiveness, public health, health economics, and health technology assessment.

Original languageEnglish
PublisherCambridge University Press
Number of pages424
ISBN (Electronic)9781139506779
ISBN (Print)9781107690479
Publication statusPublished - 1 Jan 2014


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