Application of Game Theory to Orthopaedic Surgery

Abstract

Game theory is branch of mathematical economics that pertains to decision-making and is a conceptual framework for explaining and predicting situational outcomes. 1 In game theory, the games are simplified abstractions of real-life scenarios but often accurately predict human decision-making. The principles of game theory have been applied to a wide range of disciplines including government policy, international relations, sport and military strategy, and evolutionary biology. 1,2 This article will examine some of the classic games and explore their applications to orthopaedic surgery. Game theory is the study of strategy and tactics because it pertains to predicting situational outcomes. A game is a theoretical scenario with a defined set of rules, where people (players) act rationally and in their own self-interest to maximize personal utility-money, time, points, territory, and so forth. Players are assumed to seek a personally optimal strategy independent of their opponent's decisions. Game theoretic principles often accurately predict human behavior; they can provide insight into what drives decision-making and explain how final outcomes arise that are not optimal for the group as a whole, despite individual players acting rationally. These outcomes can be viewed as the result of a conflict between decisions made in self-interest and decisions made for the mutual benefit.Game theory was originally described by mathematician John von Neumann in 1928 and introduced into popular culture by the movie "A Beautiful Mind," a 2001 Hollywood biopic of mathematician John Nash. 3 The principles of game theory have since been applied to a wide range of disciplines including government policy, international relations, sports and military strategy, and evolutionary biology. 2,4 This article will examine some of the classic games and explore their applications to orthopaedic surgery. The goal is not for surgeons to necessarily use game theory in these specific scenarios, but rather raise awareness of game theory principles so this knowledge can be applied to new situations. Once an orthopaedic surgeon is aware of game theory, its instances and applications become ubiquitous in clinic, the operating room, and in everyday life. Prisoner's DilemmaThe prisoner's dilemma is the most well-known game, and a common starting point of game theory teaching 5 (Figure 1). The classic scenario describes two

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