Clinical decision analysis in occupational medicine: Choosing the optimal FEV₁ criterion for diagnosing occupational asthma

Clinical decision analysis techniques may be particularly valuable in occupational medicine. A simple decision analysis model for choosing the “best” criterion for change in forced expiratory volume in 1 s (FEV₁) for diagnosing occupational asthma is presented. Unlike the traditional statistical approach to selecting criterion values, it considers more of the factors that affect clinical decision making, including the value of possible outcomes. This also illustrates the effect of alternate administrative goals such as maximizing benefit to the individual, minimizing cost, or optimizing the cost-benefit ratio.