Sensitivity Analysis and the Expected Value of Perfect Information

Abstract

Measures of decision sensitivity that have been applied to medical decision problems were examined. Traditional threshold proximity methods have recently been supple mented by probabilistic sensitivity analysis, and by entropy-based measures of sen sitivity. The authors propose a fourth measure based upon the expected value of perfect information (EVPI), which they believe superior both methodologically and prag matically. Both the traditional and the newly suggested sensitivity measures focus en tirely on the likelihood of decision change without attention to corresponding changes in payoff, which are often small. Consequently, these measures can dramatically over state problem sensitivity. EVPI, on the other hand, incorporates both the probability of a decision change and the marginal benefit of such a change into a single measure, and therefore provides a superior picture of problem sensitivity. To lend support to this contention, the authors revisit three problems from the literature and compare the results of sensitivity analyses using probabilistic, entropy-based, and EVPI-based mea sures. Key words: sensitivity analysis; expected value of perfect information. (Med Decis Making 1998;18:95-109)