Application of multidimensional utility theory in determining optimal test-treatment strategies for streptococcal sore throat and rheumatic fever

摘要

In most decision problems there is a need to consider both multiple objective function and uncertainty. Von Neumann-Morganstern utility theory offers a rigorous methodology for defining objectiv3es under uncertainty, and there is nothing in the theory which precludes construction and use of multiple criteria utility functions. For some types of problems feasible methods now exist for overcoming the severe practical problems of assessing such functions. This paper describes the analysis of a medical problem, the determination of optimal test and treatment strategies for streptococcal sore throat and rheumatic fever, in which the formulation, verification, and assessment of a multidimensional utility function was a critical part of the analysis. Comments on the usefulness of the procedure are made, and some potential future applications summarized. A theorem on the assessability of parameters in the utility function is also proven. (Author)