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J Am Coll Cardiol, 1990; 15:751-762
© 1990 by the American College of Cardiology Foundation
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Decision analysis in clinical cardiology: when is coronary angiography required in aortic stenosis?

S Georgeson, KB Meyer, and SG Pauker

Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.

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.


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