title: Applying principles from the game theory to acute stroke care: Learning from the prisoner's dilemma, stag-hunt, and other strategies.
abstract: BACKGROUND
  Acute stroke care represents a challenge for decision makers. Decisions based on erroneous assessments may generate false expectations of patients and their family members, and potentially inappropriate medical advice. Game theory is the analysis of interactions between individuals to study how conflict and cooperation affect our decisions.
  
  
  OBJECTIVE
  We reviewed principles of game theory that could be applied to medical decisions under uncertainty.
  
  
  CONCLUSIONS
  Medical decisions in acute stroke care are usually made under constrains: short period of time, with imperfect clinical information, limit understanding about patients and families' values and beliefs. Game theory brings some strategies to help us manage complex medical situations under uncertainty. For example, it offers a different perspective by encouraging the consideration of different alternatives through the understanding of patients' preferences and the careful evaluation of cognitive distortions when applying 'real-world' data. The stag-hunt game teaches us the importance of trust to strength cooperation for a successful patient-physician interaction that is beyond a good or poor clinical outcome.
  
  
  CONCLUSIONS
  The application of game theory to stroke care may improve our understanding of complex medical situations and help clinicians make practical decisions under uncertainty.
authors: Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Neuroeconomics and Social Neuroscience, Department of Economics, University of Zurich, Switzerland saposnikg@smh.ca.
authors: Gustavo
authors: G
authors: Saposnik
authors: Dell School of Medicine, University of Texas, Austin, TX, USA.
authors: S Claiborne
authors: SC
authors: Johnston
mesh_terms: D000818:Animals; D000066491:Clinical Decision-Making / Q000379:methods; D005716:Game Theory; D006801:Humans; D010817:Physician-Patient Relations; D000068956:Prisoner Dilemma; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
keywords: Acute stroke therapy; decision making; decision neuroscience; endovascular; game theory; neuroeconomics; outcomes; prevention; prisoners’ dilemma