Swing weighting
Subscribe to Decision Science News by Email (one email per week, easy unsubscribe)
A NEW MEDICAL DECISION MAKING BLOG
Alan Schwartz of the University of Illinois-Chicago College of Medicine has started a new blog in advance of his forthcoming book “Making Medical Decisions: A Physician’s Guide” by himself and George Bergus (Cambridge University Press, 2008). Visit the blog at Making Medical Decisions.
Today, we quote an example of the quality content you will find there. It’s on swing weighting (see Decision Analysis and Behavioral Research, by Detlov von Winterfeldt and Ward Edwards, for more)
“To use swing weighting with a set of goals and a set of treatment outcomes, you determine from the patient, how each treatment outcome would impact each of their goals.
For example, if a patient has three goals:
- Live as long as possible
- Continue working at my job
- Keep my family financially secure
and is considering three treatments (A, B, and no treatment) with known outcomes, they might perceive the situation to look like this:
|
|
Goal 1: Live as long as possible |
Goal 2: Be able to keep working |
Goal 3: Keep my family financially secure |
|
Treatment A |
Best chance for long-term survival, likely live 5+ years |
Will be unable to work for some months |
Insurance coverage sufficient to pay for procedure, disability and life insurance coverage sufficient to provide for family |
|
Treatment B |
May result in living 3-5 years or more |
Will be unable to work for some weeks |
Insurance coverage sufficient to pay for procedure, disability and life insurance coverage sufficient to provide for family |
|
No treatment |
Worst chance, likely to live no more than 2 years |
Can immediately resume work until condition worsens |
Insurance coverage sufficient to pay for procedure, disability and life insurance coverage sufficient to provide for family |
To determine the relative importance of their three goals, we ask which goal could result in the most important swing from worst possible achievement of that goal to best possible achievement. That is, if the patient were the worst possible scenario (no more than two years to live, unable to work for months, and sufficient insurance coverage), which one goal’s outcome would they want to swing to the best possible achievement? Would they prefer to improve their longevity (from “no more than 2 years” to “5+ years”), their ability to work (from “unable to work for months” to “immediately resume work”), or their financial security (from “sufficient coverage” to “sufficient coverage”)? If the patient prefers to swing Goal 1, that is considered her most important goal, and she can then proceed to choose which goal she would next choose to swing, out of those that remain”.
Photo Credit: http://www.flickr.com/photo_zoom.gne?id=1239529607
