Benign heme poses interesting decision problems, since one has to balance the risk of thrombus with the risk of bleeding.

One has to consider not just the probabilities of thrombus and bleeding, but also their potential impact on the patient. For example, a stroke is usually worse than a bleed, but a bleed might be much more likely than a stroke if the patient has had many recent bleeds.

So, in a decision framework, we have action as anticoagulation, the state as the set of patient characteristics (whether the patient is currently or has previously clotted or bled), and a reward that weights the two according to impact on the patient’s final health outcomes.