Elementary clinical decision analysis in evidence-based nephrology.
To assess the potential contribution of elementary decision analysis to evidence-based medicine in nephrology, the treatment of primary membranous nephropathy with nephrotic syndrome is taken as an example involving quantity and quality of life, and the treatment of uremic anemia in hemodialysis patients as an example involving economic constraints of interventions. Technical details on decision tree calculation procedures, outcome quantitative assessment, and probability assignment to branches are outlined. Indications strictly based on significance tests of individual outcomes of randomized controlled trials can either miss clinical advantages or disregard economic constraints that can be easily established by decision analysis and that may have a major impact in practice.
Piccoli
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Department of Medical and Surgical Sciences,  University of Padua, Italy. apiccoli@ux1.unipd.it
D003661:Decision Support Techniques; D019317:Evidence-Based Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D007558:Italy; D007674:Kidney Diseases / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D009398:Nephrology / Q000379:methods*; D011379:Prognosis; D012680:Sensitivity and Specificity; D016896:Treatment Outcome