Decision analysis, in its transparency, protects the patient’s reward function. Other rewards are often at play, such as the reward of the insurer. Decision analysis makes certain that we document which reward we are optimizing.

A recent challenge to the ACA could lead to changes that may indirectly influence certain screening test decisions in favor of the insurer’s reward rather than the patient’s reward.

However, you can imagine, based on the decision analysis framework, that this could lead to negative consequences for patients.