Byzantine Medical Problems: Decision Making with Misleading, Imperfect Information

Abstract

Medical diagnosis and treatment decision making traditionally hinges on clinical judgment, available evidence from the literature and “test results”. This information is highly imperfect and can be erroneous or frankly misleading. This chapter borrows from digital fly-by wire paradigms for processing information from unreliable sources for guiding diagnosis and treatment. A brief overview of the principles and architectures used in Airbus and Boeing Fly-By Wire systems is presented. The relevant architectures are used to inspire similar methods of thinking for medical diagnosis and treatment. This chapter extends the theory of fault tree analysis and probabilistic methods developed in prior chapters for guiding decision making in the face of uncertainty and misleading clinical information. Costs and treatment risks are incorporated into uncertainty associated with poor quality information. Medical examples are presented.