Special review: game theory to analyse management options in gastro-oesophageal reflux disease.

This study aims to demonstrate the applicability of linear programming to threshold analysis, using, as an example, patients with new onset of gastro-oesophageal reflux disease (GERD). The choice amongst competing management options is modelled as a decision tree, using threshold analysis, as well as an m x n matrix on an Excel spreadsheet. The different options of medical management correspond to the m rows, whilst the different disease states correspond to the n columns of the matrix. Each number at the intersection of a row and a column represents the outcome associated with that particular combination of management and disease state. The threshold values are calculated by the built-in functions for linear programming of Excel using its Solver tool. Varying the cost estimates in the sensitivity analysis translates into solving a set of different matrices. Threshold analysis provides a formalism to phrase problems of medical decision analysis in a concise fashion.