IMPLEMENTATION OF CONTINUOUS RISK UTILITY-ASSESSMENT - THE TOTAL HIP-REPLACEMENT DECISION

Application of utility theory to medical decision-making problems has received considerable attention in the decision analysis literature bu t has not led to widespread clinical use. Potential reasons for this s tem from the fact that standard preference assessment protocols offer choices that are too simplistic to adequately address a number of medi cal issues and can result in choices that are unrealistic and unfamili ar to the patient. Continuous risk utility assessment (CRUA) offers an alternative methodology by which more realistic assessment scenarios can be used. However, continuous risk assessment questions can be comp lex, and issues involving the suitability of CRUA to medical treatment decisions in a clinical setting need to be addressed. This paper desc ribes the use of CRUA in the treatment decision facing a patient with advanced osteoarthritis of the hip. A microcomputer-based implementati on of the CRUA protocol is presented, and the results of an evaluation of this protocol are reported. The study results indicate that CRUA i s feasible in a clinical setting and might serve a useful and valuable purpose in the clinical decision-making process.