title: Measuring decision sensitivity: a combined Monte Carlo-logistic regression approach.
abstract: Modeling of the uncertainty of multiple input variables for a complex decision problem complicates sensitivity analysis. A method of analysis comprising stochastic simulation of the model and logistic regression of the simulated dichotomous decision variable against all of the input variables yields a direct measure of the importance of input variables to the decision. This method is demonstrated on a previously analyzed clinical decision either to continue observation or to immediately treat with anticoagulants a woman presenting with deep vein thrombosis in the first trimester of pregnancy. A relative measure of the importance of each input variable in causing a change of decision is estimated by calculating the change in the log odds attributable to variation of each input variable over its range of uncertain values compared with the total change of log odds from variation of all input variables. This method is compared with alternative measures of input variable importance, and is found to be a simple yet powerful tool for gaining quantitative insight into the nuances of a decision model.
authors.affiliation: Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213.
authors.forename: J F
authors.initials: JF
authors.lastname: Merz
authors.forename: M J
authors.initials: MJ
authors.lastname: Small
authors.forename: P S
authors.initials: PS
authors.lastname: Fischbeck
mesh_terms: D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use; D003657:Decision Making; D005260:Female; D006801:Humans; D016015:Logistic Models; D009010:Monte Carlo Method; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D012044:Regression Analysis; D013924:Thrombophlebitis / Q000188:drug therapy
chemical_list: D000925:Anticoagulants