Fundamentals

What is a DecisionAL? ... TranslationAL?

A DecisionAL is an online decision support program that produces an opinion on a decision in the form of an Annalisa. The opinion comes in the form of scores for each of the included options, which combine the ratings entered into evidence panel for the performance of each option on each of the included attributes with the relative importance weightings for those attributes entered in the weightings panel via an expected value calculation. 

DecisionALs may be PersonALs/IndividuALs, relating to a decision facing an individual, or CommunALs/SociALs, relating to a policy decision facing a community.

Personal DecisionALs follow our guidelines concerning the options and attributes to be included. These reflect our overall philosophy of person-centred care in which health decisions are taken either personally, or, in shared decision making, with a professional, as determined by the individual. They are designed to be accessed directly by individuals in the community as persons, whether or not the individual is currently a patient, either formally or in self- concept.

Communal DecisionALs follow our guidelines concerning the options and attributes to be included, within an overall philosophy of citizen-centred policy. They are designed to be accessed directly by individuals who wish to arrive at an opinion on a community decision that reflects their individual importance weights on the attributes, in conjunction with the best estimates available now in the ratings panel.

A TranslationAL is, in contrast to a DecisionAL, not an original product. It is based on a published study, analysis or decision aid and re-produces or re-presents it in the Annalisa framework, with minimal intended ‘loss in translation’. The underlying aid will have been produced for use in a particular context, and it may include only options and criteria regarded as appropriate by the provider. The TranslationAL does not change these features, so it will not necessarily meet the criterion of person-centred care as defined above. In many cases the original study or aid does not produce, and is consciously not intended to produce, an opinion on the options, even less likely an opinion in the form of scores for all the included options. The TranslationAL has this as its main aim.

TranslationALs may also be either PersonAL or CommunAL and that will be clear from the nature of the underlying study, analysis or aid.

Examples:

PersonAL DecisionAL: Should I accept an offer of being screened for bowel cancer?

CommunAL DecisionAL: Should we have a bowel cancer screening programme?

PersonAL TranslationAL: Should I accept an offer of screening for bowel cancer? 

CommunAL TranslationAL: Should we have a bowel cancer screening programme? 

The final classification of our programs relates to the nature of the topic. Here we draw a very broad distinction between PromotionALs, in which the options are concerned with promoting health in some way, typically in order to prevent a condition developing or existing undetected, and ConditionALs in which the options are interventions to address existing and known conditions.