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Use of Decision Analysis and the Delphi Technique

Jeffrey P. Koplan, MD, MPH; Laurence S. Farer, MD, MPH

JAMA. 1980;244(24):2736-2740.

Abstract
Proper care of persons infected with isoniazid-resistant tubercle bacilli is controversial because there are few data on the risks and benefits of the preventive treatment alternatives. Decision analysis was used to facilitate a comparison of outcomes using different strategies and the Delphi technique to obtain estimates of relevant probabilities. For all probabilities of isoniazid resistance, the observation and no-drug alternative is unsatisfactory because it would result in a twofold to sevenfold greater number of tuberculosis cases than any of the drug regimens. With a low probability of isoniazid resistance, isoniazid is the preventive treatment of least cost and proved efficacy. As the probability of isoniazid resistance increases, more cases are prevented by rifampin-containing regimens, but at added cost. These findings can be used to formulate appropriate preventive treatment recommendations.

(JAMA 1980;244:2736-2740)

Author Affiliations
From the Office of Program Planning and Evaluation and Tuberculosis Control Division, Bureau of State Services, Center for Disease Control, Atlanta.

Footnotes
Reprint requests to Bureau of State Services, attn: Technical Information Services, Center for Disease Control, Atlanta, GA 30333.

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