A comparison of decision analysis and second opinions for surgical decisions

J. R. Clarke

Second opinions and decision analysis, a mathematical process the decision maker can use to represent and solve problems, were compared in hypothetical surgical situations. Fifty expert surgeons gave opinions and provided the information necessary to solve the problems by decision analyses. Each surgeon's opinion was randomly selected again as a second opinion. In six difficult cases, 59% of the individual opinions were correct when compared with previously determined answers. For two surgical second-opinion protocols, the accuracies were 54% and 60%. The accuracy of the decision analyses was 69%. Improvement from second-opinion protocols can be predicted mathematically and is limited. Improvement from decision analysis is not limited by mathematical constraints. Decision analysis may be preferable to second opinions in verifying surgical decisions.