Decision analysis in clinical cardiology: when is coronary angiography required in aortic stenosis?
Decision analysis offers a reproducible, explicit approach to complex clinical decisions. It consists of developing a model, typically a decision tree, that separates choices from chances and that specifies and assigns relative values to outcomes. Sensitivity analysis allows exploration of alternative assumptions. Cost-effectiveness analysis shows the relation between dollars spent and improved health outcomes achieved. In a tutorial format, this approach is applied to the decision whether to perform coronary angiography in a patient who requires aortic valve replacement for critical aortic stenosis.
Georgeson
S
S
Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
Meyer
K B
KB
Pauker
S G
SG
D000792:Angiography; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D004176:Dipyridamole; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D004176:Dipyridamole