Expert testimony based on decision analysis: a malpractice case report.
OBJECTIVE
Expert testimony in malpractice cases is often subjective and biased. Decision-analytic techniques might provide an objective basis for such testimony.


METHODS
Case report. This article reports the case of a patient with chest pain that resulted in a malpractice suit alleging a delay in diagnosis of coronary artery disease.


METHODS
The case occurred in a private practice; the expert witnesses and the decision analysis originated from a university teaching hospital.


METHODS
A decision tree and threshold analysis were used to define the thresholds of disease probability at which either testing or treatment should be implemented. The expert testimony of two witnesses that exercise stress testing was the standard of care was compared with the results of the decision analysis.


RESULTS
Decision analysis supported the view that cardiac catheterization would have been the more appropriate test.


CONCLUSIONS
Techniques of decision analysis provide a structured and quantitative basis for empirical judgment and may help to minimize current problems with expert testimony.
Weir
S S
SS
Department of Family Medicine, University of North Carolina, Chapel Hill 27599.
Curtis
P
P
McNutt
R A
RA
D002637:Chest Pain / Q000175:diagnosis; D003327:Coronary Disease / Q000175:diagnosis*; D003661:Decision Support Techniques; D003663:Decision Trees; D005104:Expert Testimony; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged