A Journey to Real-World Decision Problems

  • Subhash Pokhrel
  • Lesley Owen
  • Kathryn Coyle
  • Doug Coyle


The principal aim of return on investment (ROI) analysis is to support decisions as it provides a decision maker with explicit data about the costs and consequences of alternative courses of action. Three questions dominate a decision maker’s dilemma: do I invest, do I invest more, do I disinvest? These questions are not necessarily mutually exclusive. Real-world decisions are complex to make and therefore the decision problems must be defined appropriately. This chapter shows how the PICO (population, intervention, comparator and outcomes) framework can be helpful in framing the decision problem at hand.


Decision making Return on investment ROI PICO 


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Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Subhash Pokhrel
    • 1
  • Lesley Owen
    • 2
  • Kathryn Coyle
    • 3
  • Doug Coyle
    • 4
  1. 1.Health Economics Research Group (HERG), Division of Health SciencesBrunel University LondonUxbridgeUK
  2. 2.Centre for GuidelinesNational Institute for Health and Care ExcellenceLondonUK
  3. 3.Health Economics Research Group (HERG)Brunel University LondonUxbridgeUK
  4. 4.School of Epidemiology and Public HealthUniversity of OttawaOttawaCanada

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