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Decision Making with Respect to Diagnostic Testing

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  • John Cairns
  • Phil Shackley
  • Vanora Hundley

Abstract

This paper outlines a model for valuing the benefits of antenatal screening based on the analysis of individual decision making with respect to consequent diagnostic test ing. Central to the model is the idea that the benefits of screening can be measured by valuing the improved information generated from screening. The model is developed in the context of antenatal carrier screening for cystic fibrosis (CF). Benefits are as sessed by surveying women in the general population in order to establish their pref erences for two alternative methods of CF carrier screening—stepwise and couple screening. Preferences are elicited using standard-gamble questions in which women from a population-based random sample are asked to trade off risk of fetal loss with improved information from diagnostic testing. A series of standard-gamble questions is employed to elicit utility values for each of the possible information outcomes from screening. The expected utilities of both screening methods are calculated at both individual and group levels. The results suggest that the use of individual decision making with respect to diagnostic testing as a means of valuing the benefits of screen ing may have wide applications. Key words: benefits; antenatal screening; information; standard gamble; expected utility. (Med Decis Making 1996;16:161-168)

Suggested Citation

  • John Cairns & Phil Shackley & Vanora Hundley, 1996. "Decision Making with Respect to Diagnostic Testing," Medical Decision Making, , vol. 16(2), pages 161-168, June.
    • Handle: RePEc:sae:medema:v:16:y:1996:i:2:p:161-168
    DOI: 10.1177/0272989X9601600208
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    References listed on IDEAS

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    1. Botkin, J.R. & Alemagno, S., 1992. "Carrier screening for cystic fibrosis: A pilot study of the attitudes of pregnant women," American Journal of Public Health, American Public Health Association, vol. 82(5), pages 723-725.
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    Cited by:

    1. Stavros Petrou, 2001. "Methodological limitations of economic evaluations of antenatal screening," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 775-778, December.
    2. Cam Donaldson & Phil Shackley & Mona Abdalla, 1997. "Using Willingness To Pay To Value Close Substitutes: Carrier Screening for Cystic Fibrosis Revisited," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 145-159, March.
    3. Peter J. Neumann & Joshua T. Cohen & James K. Hammitt & Thomas W. Concannon & Hannah R. Auerbach & ChiHui Fang & David M. Kent, 2012. "Willingness‐to‐pay for predictive tests with no immediate treatment implications: a survey of US residents," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 238-251, March.

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    1. Shackley, Phil & Cairns, John, 1996. "Evaluating the benefits of antenatal screening: an alternative approach," Health Policy, Elsevier, vol. 36(2), pages 103-115, May.
    2. Cam Donaldson & Phil Shackley & Mona Abdalla & Zosia Miedzybrodzka, 1995. "Willingness to pay for antenatal carrier screening for cystic fibrosis," Health Economics, John Wiley & Sons, Ltd., vol. 4(6), pages 439-452, November.
    3. John Cairns & Phil Shackley, 1993. "Sometimes sensitive, seldom specific: A review of the economics of screening," Health Economics, John Wiley & Sons, Ltd., vol. 2(1), pages 43-53, April.

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