题目
RSM470H1 F LEC0101 In-Class Exercise 10
单项选择题
Dr. Switzer has a seriously ill patient but has had trouble diagnosing the specific cause of the illness. The doctor now has narrowed the cause down to two alternatives: disease A or disease B. Based on the evidence so far, she feels that the two alternatives are equally likely. Beyond the testing already done, there is no test available to determine if the cause is disease B. One test is available for disease A, but it has two major problems. First, it is very expensive. Second, it is somewhat unreliable, giving an accurate result only 80 percent of the time. Thus, it will give a positive result (indicating disease A) for only 80 percent of patients who have disease A, whereas it will give a positive result for 20 percent of patients who actually have disease B instead. Disease B is a very serious disease with no known treatment. It is sometimes fatal, and those who survive remain in poor health with a poor quality of life thereafter. The prognosis is similar for victims of disease A if it is left untreated. However, there is a fairly expensive treatment available that eliminates the danger for those with disease A, and it may return them to good health. Unfortunately, it is a relatively radical treatment that always leads to death if the patient actually has disease B instead. The probability distribution for the prognosis for this patient is given for each case in the following table, where the column headings (after the first one) indicate the disease for the patient. The patient has assigned the following utilities to the possible outcomes. In addition, these utilities should be incremented by -2 if the patient incurs the cost of the test for disease A and by -1 if the patient (or the patient's estate) incurs the cost of the treatment for disease A. Using decision analysis via Bayes' rule, and a complete decision tree, which is the best strategy for the patient?
选项
A.Do not test, do not receive any treament
B.Do not test, receive treatement for disease A anyway
C.Take the test for disease A. If positive, receive treatement for disease A
D.Take the test for disease A. If positive, do NOT receive the treatment anyway
E.Take the test for disease A. If negative, receive treatement for disease A anyway
F.Take the test for disease A. If negative, do NOT receive treatement for disease A

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标准答案
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思路分析
The scenario presents a decision analysis problem where the patient weighs testing for disease A versus immediately treating or not treating, given test characteristics (sensitivity and specificity both 0.80) and the severe consequences of misdiagnosis. The utilities provided (Die = 0, Survive with poor health = 10, Return to good health = 30) are augmented by test and treatment costs (-2 for taking the test for disease A, -1 for the treatment cost of disease A). These pieces together drive the expected utilities of each strategy through Bayes’ rule and a decision tree.
Option 1: Do not test, do not receive any treatment
- Why this might be considered: it avoids test cost and avoids potential treatment risks.
- Why it is weak here: disease B has a serious prognosis and there is an available treatment for disease A that can restore health; skipping both testing and treatment forfeits the potential benefit of curing A and accepts potentially poor outcomes if A is present. The lack of treatment for A when A is actually present leads to worse expected outcomes, especially since B has no good treatment and A can be treated with a potentially curative ......Login to view full explanation登录即可查看完整答案
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