Comparing risks of alternative medical diagnosis using Bayesian arguments

Authors:
Norman Fenton;Martin Neil
Affiliations:
Queen Mary University of London, RADAR (Risk Assessment and Decision Analysis Research), School of Electronic Engineering and Computer Science, London E1 4NS, UK and Agena Ltd., 32-33 Hatton Garde ...;Queen Mary University of London, RADAR (Risk Assessment and Decision Analysis Research), School of Electronic Engineering and Computer Science, London E1 4NS, UK and Agena Ltd., 32-33 Hatton Garde ...
Venue:
Journal of Biomedical Informatics
Year:
2010

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Abstract

This paper explains the role of Bayes Theorem and Bayesian networks arising in a medical negligence case brought by a patient who suffered a stroke as a result of an invasive diagnostic test. The claim of negligence was based on the premise that an alternative (non-invasive) test should have been used because it carried a lower risk. The case raises a number of general and widely applicable concerns about the decision-making process within the medical profession, including the ethics of informed consent, patient care liabilities when errors are made, and the research problem of focusing on 'true positives' while ignoring 'false positives'. An immediate concern is how best to present Bayesian arguments in such a way that they can be understood by people who would normally balk at mathematical equations. We feel it is possible to present purely visual representations of a non-trivial Bayesian argument in such a way that no mathematical knowledge or understanding is needed. The approach supports a wide range of alternative scenarios, makes all assumptions easily understandable and offers significant potential benefits to many areas of medical decision-making.