Treatment of intact XXXX : a decision-analytical approach.

@entity1 @entity425 @entity51 @entity2026 @entity439 @entity397 @entity438
Clinical decision analysis is applied to the treatment decisions for four @entity1 with unruptured @entity439 . The surgical treatment was uneventful in all @entity1 except one with mild mixed @entity2026 and @entity425 postoperatively; these @entity51 in less than 2 years. In the decision analysis, discounted Quality Adjusted Life Years are used as an outcome measure. Probability estimates are extracted from the literature when available. It is concluded that the decision to treat the @entity439 neurosurgically in three of the four @entity1 was correct. In two of these three @entity1 , the decision cannot be altered by plausible changes in estimated data. For the third @entity1 , only the combination of a low probability of @entity397 , a high surgical mortality and morbidity, and high discount favors conservative treatment. In the fourth @entity1 , a toss-up situation exists. More knowledge of the probability of @entity397 , the probability of the development of other @entity439 , and the results of operation on intact @entity438 would have made the analysis more accurate. Clinical research should address these issues.
