Exploiting decision theory for supporting therapy selection in computerized clinical guidelines Stefania Montani, Paolo Terenziani, Alessio Bottrighi DI, Università del Piemonte Orientale “Amedeo Avogadro”, Alessandria, Italy

Decision support  Computer-based treatment of GL to support (therapeutic) decisions  Therapy selection may be critical –Clinically equivalent alternatives  Several decisions in sequence may be prompted (dynamic decision problem) –Simulation and collection of global decision parameters (utility, costs, duration)

Mapping decision theory concepts to clinical GL (1)  Decision theory: a natural candidate for decision support  Mapping of concepts between the two areas –Each decision is based on a data collection completed at decision time –Does not depend on the previous history Markov assumption Discrete time process Completely observable –Markov Decision Process (MDP)

Exploiting DT algorithms in the GL management domain  Implementation issues –Classical algorithms –Integrations and specific choices to deal with non trivial GL control flow constructs  Calculation of the optimal policy  Calculation of the expected utility along a given GL path  Sharable across different GL management systems  Implementation in GLARE: a system for acquiring, representing and executing clinical GL