A Comparison of Decision Analysis and Second Opinions for Surgical Decisions

doi:10.1001/archsurg.1985.01390310080018

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Vol. 120 No. 7, July 1985

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A Comparison of Decision Analysis and Second Opinions for Surgical Decisions

John R. Clarke, MD

Arch Surg. 1985;120(7):844-847.

Abstract

• Second opinions and decision analysis, a mathematicalprocess the decision maker can use to represent and solve problems,were compared in hypothetical surgical situations. Fifty expertsurgeons gave opinions and provided the information necessaryto solve the problems by decision analyses. Each surgeon's opinionwas randomly selected again as a second opinion. In six difficultcases, 59% of the individual opinions were correct when comparedwith previously determined answers. For two surgical second-opinionprotocols, the accuracies were 54% and 60%. The accuracy ofthe decision analyses was 69%. Improvement from second-opinionprotocols can be predicted mathematically and is limited. Improvementfrom decision analysis is not limited by mathematical constraints.Decision analysis may be preferable to second opinions in verifyingsurgical decisions.

(Arch Surg 1985;120:844-847)

Author Affiliations

From the Department of Surgery, The Medical College of Pennsylvania, Philadelphia.

Footnotes

Accepted for publication Dec 11, 1984.

Reprint requests to Department of Surgery, The Medical Collegeof Pennsylvania, 3300 Henry Ave, Philadelphia, PA 19129 (DrClarke).

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