{"id":253,"date":"2007-08-29T01:49:35","date_gmt":"2007-08-29T00:49:35","guid":{"rendered":"http:\/\/www.decisionsciencenews.com\/?p=253"},"modified":"2007-08-29T01:51:20","modified_gmt":"2007-08-29T00:51:20","slug":"swing-weighting","status":"publish","type":"post","link":"https:\/\/www.decisionsciencenews.com\/?p=253","title":{"rendered":"Swing weighting"},"content":{"rendered":"<p>A NEW MEDICAL DECISION MAKING BLOG<\/p>\n<p style=\"text-align: center\"><img decoding=\"async\" src=\"http:\/\/www.decisionsciencenews.com\/wp-content\/uploads\/2007\/08\/swg.jpg\" alt=\"swg\" \/><\/p>\n<p>Alan Schwartz of the University of Illinois-Chicago College of Medicine has started a new blog in advance of his forthcoming book \u201cMaking Medical Decisions: A Physician\u2019s Guide\u201d by himself and George Bergus (Cambridge University Press, 2008).  Visit the blog at <a href=\"http:\/\/www.makingmedicaldecisions.com\" target=\"_blank\">Making Medical Decisions<\/a>.<\/p>\n<p>Today, we quote <a href=\"http:\/\/www.makingmedicaldecisions.com\/2006\/goals-and-swing-weighting\" target=\"_blank\">an example<\/a> of the quality content you will find there. It&#8217;s on <em>swing weighting <\/em>(see <cite>Decision Analysis and Behavioral Research<\/cite>, by Detlov von Winterfeldt and Ward Edwards, for more)<\/p>\n<blockquote><p>&#8220;To use swing weighting with a set of goals and a set of treatment outcomes, you determine from the patient, how each treatment outcome would impact each of their goals.<\/p>\n<p>For example, if a patient has three goals:<\/p>\n<ul>\n<li>Live as long as possible<\/li>\n<li>Continue working at my job<\/li>\n<li>Keep my family financially secure<\/li>\n<\/ul>\n<p>and is considering three treatments (A, B, and no treatment) with known outcomes, they might perceive the situation to look like this:<\/p><\/blockquote>\n<table style=\"border: medium none ; border-collapse: collapse\" class=\"MsoTableGrid\" border=\"1\" cellpadding=\"0\" cellspacing=\"0\">\n<tr>\n<td style=\"border: 1pt solid windowtext; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">&nbsp;<\/p>\n<\/td>\n<td style=\"border-style: solid solid solid none; border-color: windowtext windowtext windowtext -moz-use-text-color; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Goal 1: Live as   long as possible<\/p>\n<\/td>\n<td style=\"border-style: solid solid solid none; border-color: windowtext windowtext windowtext -moz-use-text-color; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Goal 2: Be able   to keep working<\/p>\n<\/td>\n<td style=\"border-style: solid solid solid none; border-color: windowtext windowtext windowtext -moz-use-text-color; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Goal 3: Keep my   family financially secure<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Treatment A<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Best chance for   long-term survival, likely live 5+ years<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Will be unable   to work for some months<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Insurance   coverage sufficient to pay for procedure, disability and life insurance   coverage sufficient to provide for family<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Treatment B<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">May result in living 3-5 years or more<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Will be unable   to work for some weeks<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Insurance   coverage sufficient to pay for procedure, disability and life insurance   coverage sufficient to provide for family<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"border-style: none solid solid; border-color: -moz-use-text-color windowtext windowtext; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">No treatment<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Worst chance,   likely to live no more than 2 years<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Can immediately   resume work until condition worsens<\/p>\n<\/td>\n<td style=\"border-style: none solid solid none; border-color: -moz-use-text-color windowtext windowtext -moz-use-text-color; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 160px\" valign=\"top\">\n<p class=\"MsoBodyText\">Insurance   coverage sufficient to pay for procedure, disability and life insurance   coverage sufficient to provide for family<\/p>\n<\/td>\n<\/tr>\n<\/table>\n<blockquote><p>To determine the relative importance of their three goals, we ask which goal could result in the most important swing from worst possible achievement of that goal to best possible achievement. That is, if the patient were the worst possible scenario (no more than two years to live, unable to work for months, and sufficient insurance coverage), which one goal\u2019s outcome would they want to swing to the best possible achievement? Would they prefer to improve their longevity (from \u201cno more than 2 years\u201d to \u201c5+ years\u201d), their ability to work (from \u201cunable to work for months\u201d to \u201cimmediately resume work\u201d), or their financial security (from \u201csufficient coverage\u201d to \u201csufficient coverage\u201d)? If the patient prefers to swing Goal 1, that is considered her most important goal, and she can then proceed to choose which goal she would next choose to swing, out of those that remain&#8221;.<\/p><\/blockquote>\n<p><font size=\"1\">Photo Credit: http:\/\/www.flickr.com\/photo_zoom.gne?id=1239529607<\/font><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A NEW MEDICAL DECISION MAKING BLOG Alan Schwartz of the University of Illinois-Chicago College of Medicine has started a new blog in advance of his forthcoming book \u201cMaking Medical Decisions: A Physician\u2019s Guide\u201d by himself and George Bergus (Cambridge University Press, 2008). Visit the blog at Making Medical Decisions. Today, we quote an example of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[2,10],"tags":[],"class_list":["post-253","post","type-post","status-publish","format-standard","hentry","category-research-news","category-sjdm"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p4LKj-45","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=\/wp\/v2\/posts\/253","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=253"}],"version-history":[{"count":0,"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=\/wp\/v2\/posts\/253\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=253"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=253"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.decisionsciencenews.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=253"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}