The Determination of Sequential Strategies of Diagnostic Tests: Comparison of Different Methods by Simulation

Various heuristic processes for determining diagnostic test strategies were compared with the optimal sequential strategy on simulated patients. These heuristics consisted in limiting the depth and breadth of the search in the decision tree with regard to medically reasonable constraints. It appeared that some of these heuristics required a very small amount of computer time and provided solutions, the costs of which were very close to the cost of the optimal strategy.

General conclusions were drawn from an analysis of the performance of these various heuristics for varying cost functions.

Verschiedene heuristische Prozesse zur Bestimmung diagnostischer Prüfungsstrategien wurden mit der optimalen sequentiellen Strategie bei simulierten Patienten verglichen. Diese Heuristik bestand darin, die Tiefe und Breite des Suchens im Entscheiclungsbaum medizinisch sinnvollen Beschränkungen zu unterwerfen. Es ergab sich, daß einige dieser heuristischen Prozesse sehr wenig Computerzeit erforderten und Lösungen boten, deren Kosten denen der optimalen Strategie sehr nahe kamen. Aus einer Analyse der Leistung dieser verschiedenen heuristischen Prozesse werden allgemeine Rückschlüsse für unterschiedliche Kostenfunktionen gezogen.

Key-Words

Sequential Diagnostic Strategies - Optimal Strategy - Heuristics - Cost Function

Schlüssel-Wörter

Sequentielle diagnostische Strategien - optimale Strategie - Heuristik - Kostenfunktion

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