Decision analysis as the basis for computer-aided management of acute renal failure

In recent years many attempts have been made to use the computer as an aid to diagnosis, but little has been done to exploit the potential of computer technology as a more general aid to decision making. We describe the use of the discipline of decision analysis as the basis for an experimental interactive computer program designed to assist the physician in the clinical management of acute oliguric renal failure. The program deals with alternative courses of action, either tests or treatments, for which the potential risks or benefits may be large, and it balances the anticipated risk of a given strategy against the anticipated benefit that it offers the patient. The appraisals of the different courses of action open to the physician are expressed in quantitative terms as expected value. The program has been evaluated by comparing its recommendations to those of experienced nephrologists in 18 simulated cases of acute oliguric renal failure.