title: The art of management decision making: from intuition to evidence-based medicine.
abstract: This article summarizes available evidence on various management options for vestibular schwannoma as they relate to the decision-making strategies used in selection. After a brief consideration of individual options, the literature directly comparing two or more management options is examined, noting the level of evidence supporting their claims. A discussion of the strategies developed to guide decision making follows. The article closes with a summary of the evidence-based findings and suggestions for further research. The focus is on management of sporadic, unilateral vestibular schwannomas, because patients with neurofibromatosis type 2 pose different management problems best discussed separately.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Sameer A
authors.initials: SA
authors.lastname: Sheth
authors.forename: Churl-Su
authors.initials: CS
authors.lastname: Kwon
authors.forename: Fred G
authors.initials: FG
authors.lastname: Barker
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D019468:Disease Management; D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods; D011379:Prognosis; D011788:Quality of Life; D016634:Radiosurgery / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D017751:Safety Management; D016896:Treatment Outcome