DecisionTheoretic Refinement Planning in Medical Decision Making: Management of Acute Deep Venous Thrombosis
Peter Haddawy, Ph.D. AnHai Doan, B.S. Charles E. Kahn, Jr., M.D.
Department of Electrical Engineering and Computer Science, University of Wisconsin Milwaukee, Milwaukee, Wisconsin 53201.
Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
Decisiontheoretic refinement planning is a new technique for finding optimal courses of ac tion. The authors sought to determine whether this technique could identify optimal strate gies for medical diagnosis and therapy. An existing model of acute deep venous thrombosis (DVT) of the lower extremities was encoded for analysis by the drips decisiontheoretic refinement planning system. The encoding represented 6,206 possible plans. The drips planner used abstraction techniques to eliminate 5,551 plans (89%) from consideration with out examining them explicitly. It determined that, given the parameters specified, the most costeffective management strategy was ``no tests, no treatment.'' This result differed from the published result of ``perform ultrasonography, treat if positive''; drips had revealed an error in the reference article's manually constructed decision trees. We conclude that decisiontheoretic planning is useful for examining large medical decision problems, and that it can help reduce errors introduced by manual construction of decision trees.