Using observational data for decision analysis and economic analysis.

In orthopaedic surgery, clinical decisions must often be made with imperfect information from observational studies and limited resources. Decision analysis and cost-effectiveness analysis have emerged as evidence-based tools to assist in making choices in situations in which uncertainty exists. This review demonstrates how decision-analysis and cost-effectiveness-analysis tools can be used to expand on published observational studies within the context of a specific clinical scenario. Critical evaluation of clinical and economic data is of increasing importance in today's health-care delivery climate. The use of decision analysis and cost-effectiveness analysis as tools to augment observational studies can assist clinicians, patients, and policy makers in choosing techniques that will optimize benefits. A clear understanding of and the ability to use and apply these tools will allow surgeons to participate effectively in health-policy decisions to enhance the overall quality and efficiency of care that is delivered.