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Hidden ethical issues in clinical decision analysis.

In recent years, decision analysis has been increasingly advocated as a means of solving complicated clinical problems. These problems tend to involve numerous variables that must be carefully weighed before a solution can be proposed. For example, an article demonstrating the application of decision analysis to renal vasculitis and stomach ulcerations recently appeared in the Journal. 1 The rationale for using this method is that intuitive answers to clinical problems may not always be the most accurate. Instead, a decision tree is constructed that incorporates known values about disease frequency, disease mortality and morbidity, treatment toxicity, and accuracy and ill . . .