title: Graphical representation of life paths to better convey results of decision models to patients.
abstract: The inclusion of patients' perspectives in clinical practice has become an important matter for health professionals, in view of the increasing attention to patient-centered care. In this regard, this report illustrates a method for developing a visual aid that supports the physician in the process of informing patients about a critical decisional problem. In particular, we focused on interpretation of the results of decision trees embedding Markov models implemented with the commercial tool TreeAge Pro. Starting from patient-level simulations and exploiting some advanced functionalities of TreeAge Pro, we combined results to produce a novel graphical output that represents the distributions of outcomes over the lifetime for the different decision options, thus becoming a more informative decision support in a context of shared decision making. The training example used to illustrate the method is a decision tree for thromboembolism risk prevention in patients with nonvalvular atrial fibrillation.
authors.affiliation: University of Pavia, Italy (SR, CR, LS, EP, SQ)|University of Piemonte Orientale, Alessandria, Italy (SR)
authors.forename: Stefania
authors.initials: S
authors.lastname: Rubrichi
authors.affiliation: University of Pavia, Italy (SR, CR, LS, EP, SQ)|Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy (CR)
authors.forename: Carla
authors.initials: C
authors.lastname: Rognoni
authors.affiliation: University of Pavia, Italy (SR, CR, LS, EP, SQ)
authors.forename: Lucia
authors.initials: L
authors.lastname: Sacchi
authors.affiliation: University of Pavia, Italy (SR, CR, LS, EP, SQ)
authors.forename: Enea
authors.initials: E
authors.lastname: Parimbelli
authors.affiliation: IRCCS Foundation "S. Maugeri," Pavia, Italy (CN, AM).
authors.forename: Carlo
authors.initials: C
authors.lastname: Napolitano
authors.affiliation: IRCCS Foundation "S. Maugeri," Pavia, Italy (CN, AM).
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazzanti
authors.affiliation: University of Pavia, Italy (SR, CR, LS, EP, SQ)
authors.forename: Silvana
authors.initials: S
authors.lastname: Quaglini
mesh_terms: D001281:Atrial Fibrillation / Q000188:drug therapy; D003657:Decision Making; D003663:Decision Trees; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008390:Markov Chains; D010358:Patient Participation / Q000379:methods*; D010817:Physician-Patient Relations; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents
keywords: Markov models; Monte Carlo simulation; risk communication; shared decision-making; time-based reporting