Clinical Decision Analysis and Markov Modeling for Surgeons: An Introductory Overview.

Abstract:

:This study addresses the use of decision analysis and Markov models to make contemplated decisions for surgical problems. Decision analysis and decision modeling in surgical research are increasing, but many surgeons are unfamiliar with the techniques and are skeptical of the results. The goal of this review is to familiarize surgeons with techniques and terminology used in decision analytic papers, to provide the reader a practical guide to read these papers, and to ensure that surgeons can critically appraise the quality of published clinical decision models and draw well founded conclusions from such reports.First, a brief explanation of decision analysis and Markov models is presented in simple steps, followed by an overview of the components of a decision and Markov model. Subsequently, commonly used terms and definitions are described and explained, including quality-adjusted life-years, disability-adjusted life-years, discounting, half-cycle correction, cycle length, probabilistic sensitivity analysis, incremental cost-effectiveness ratio, and the willingness-to-pay threshold.Finally, the advantages and limitations of research with Markov models are described, and new modeling techniques and future perspectives are discussed. It is important that surgeons are able to understand conclusions from decision analytic studies and are familiar with the specific definitions of the terminology used in the field to keep up with surgical research. Decision analysis can guide treatment strategies when complex clinical questions need to be answered and is a necessary and useful addition to the surgical research armamentarium.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Hogendoorn W,Moll FL,Sumpio BE,Hunink MG

doi

10.1097/SLA.0000000000001569

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

268-74

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

264

pub_type

杂志文章,评审
  • Intestinal Oxygenation and Survival After Surgery for Necrotizing Enterocolitis: An Observational Cohort Study.

    abstract:OBJECTIVE:To assess whether regional intestinal oxygen saturation (rintSO2) and regional cerebral oxygen saturation (rcSO2) measurements aid in estimating survival of preterm infants after surgery for NEC. SUMMARY OF BACKGROUND DATA:Predicting survival after surgery for NEC is difficult yet of the utmost importance fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003913

    authors: Kuik SJ,van der Heide M,Bruggink JLM,Bos AF,Verhagen AAE,Kooi EMW,Hulscher JBF

    更新日期:2020-04-20 00:00:00

  • Visceral blood flow following thermal injury.

    abstract::To determine if visceral blood flow was altered by thermal injury, effective renal blood flow (ERBF) was measured by para-aminohippurate clearance in five control subjects and 13 nonbacteremic burn patients (mean burn size: 50% total body surface, range: 24.5-83.5) 6-25 days after burn injury. Splanchnic blood flow (S...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198101000-00018

    authors: Aulick LH,Goodwin CW Jr,Becker RA,Wilmore DW

    更新日期:1981-01-01 00:00:00

  • True Short Esophagus in Gastro-esophageal Reflux Disease: Old Controversies With New Perspectives.

    abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003582

    authors: Lugaresi M,Mattioli B,Daddi N,Bassi F,Pilotti V,Ferruzzi L,Mattioli S

    更新日期:2019-09-03 00:00:00

  • Effect of lymphatic mapping on diagnosis and treatment of patients with T1a, T1b favorable breast cancer.

    abstract:OBJECTIVE:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.SLA.0000071564.27229.A9

    authors: Jakub JW,Ebert MD,Diaz NM,Cantor A,Reintgen DS,Dupont EL,Shons AR,Cox CE

    更新日期:2003-06-01 00:00:00

  • Operative management of renovascular hypertension.

    abstract::From 1966 to 1975, 38 patients underwent 42 procedures for renovascular hypertension; 35 operations were aortorenal bypasses and 7 were nephrectomies. Forty-five per cent of the patients were cured, 43% were improved and 12% were unimproved. There were no operative deaths and only three late deaths. Two grafts occlude...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197512000-00019

    authors: McCombs PR,Berkowitz HD,Roberts B

    更新日期:1975-12-01 00:00:00

  • Surgeon-related factors and outcome in rectal cancer.

    abstract:OBJECTIVE:To determine whether surgical subspecialty training in colorectal surgery or frequency of rectal cancer resection by the surgeon are independent prognostic factors for local recurrence (LR) and survival. SUMMARY BACKGROUND DATA:Variation in patient outcome in rectal cancer has been shown among centers and am...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00000658-199802000-00001

    authors: Porter GA,Soskolne CL,Yakimets WW,Newman SC

    更新日期:1998-02-01 00:00:00

  • The comparative survivals of alcoholics versus nonalcoholics after distal splenorenal shunt.

    abstract::Survival after distal splenorenal shunt in appreciably better in nonalcoholic patients than in alcoholics. This increase in survival does not appear to be dependent upon the state of biochemical liver function or the severity of changes in liver histology since these latter were similar for both groups. We suggest tha...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197805000-00008

    authors: Zeppa R,Hensley GT,Levi JU,Bergstresser PR,Hutson DG Sr,Livingstone AS,Schiff ER,Fink P

    更新日期:1978-05-01 00:00:00

  • Weight Loss, Satiety, and the Postprandial Gut Hormone Response After Esophagectomy: A Prospective Study.

    abstract:OBJECTIVE:To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND:With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001918

    authors: Elliott JA,Docherty NG,Eckhardt HG,Doyle SL,Guinan EM,Ravi N,Reynolds JV,Roux CWL

    更新日期:2017-07-01 00:00:00

  • Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

    abstract:OBJECTIVE:The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. BACKGROUND:Training on VR simulators has been shown to improve technical performance in the operating room (OR). Current...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000000254

    authors: Palter VN,Grantcharov TP

    更新日期:2014-03-01 00:00:00

  • Clinical significance of the mesorectal extension of rectal cancer: a Japanese multi-institutional study.

    abstract:OBJECTIVE:The aim of this study was to emphasize the importance of a subclassification in the TNM staging system of rectal cancer. BACKGROUND:The clinical significance of the mesorectal extension of rectal cancer is unclear. PATIENTS AND METHODS:Data from 463 consecutive patients with stage IIa disease (T3N0) undergo...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0b013e3182119331

    authors: Shirouzu K,Akagi Y,Fujita S,Ueno H,Takii Y,Komori K,Ito M,Sugihara K,Japanese Society for Cancer of the Colon and Rectum (JSCCR) on Clinical Significance of the Mesorectal Extension of Rectal Cancer.

    更新日期:2011-04-01 00:00:00

  • Role of arteriography in rectal hemorrhage due to arteriovenous malformations and diverticulosis.

    abstract::Nine patients with arteriographic right colon arteriovenous malformations (AVM's) are reviewed. Even though five of the eight surviving patients had diverticulosis in remaining colon, right colectomy with removal of the AVM effectively controlled bleeding in seven of the eight patients in follow-up intervals of 14-66 ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197908000-00013

    authors: Talman EA,Dixon DS,Gutierrez FE

    更新日期:1979-08-01 00:00:00

  • Improvement in treatment results and long-term survival of patients with esophageal cancer: impact of chemoradiation and change in treatment strategy.

    abstract:OBJECTIVE:To identify prognostic factors and reasons for improved survival over time in patients with esophageal cancer. SUMMARY BACKGROUND DATA:Management strategies for esophageal cancer have evolved with time. The impact of chemoradiation in the overall treatment results has not been adequately studied. METHODS:Fr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000086545.45918.ee

    authors: Law S,Kwong DL,Kwok KF,Wong KH,Chu KM,Sham JS,Wong J

    更新日期:2003-09-01 00:00:00

  • A Study of Clinical Coding Accuracy in Surgery: Implications for the Use of Administrative Big Data for Outcomes Management.

    abstract:BACKGROUND:Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. METHODS:We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisci...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000851

    authors: Nouraei SA,Hudovsky A,Frampton AE,Mufti U,White NB,Wathen CG,Sandhu GS,Darzi A

    更新日期:2015-06-01 00:00:00

  • Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease: Results of a Prospective Nationwide Cohort.

    abstract:OBJECTIVE:To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD). SUMMARY BACKGROUND DATA:The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. METHODS:Fr...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002017

    authors: Brouquet A,Maggiori L,Zerbib P,Lefevre JH,Denost Q,Germain A,Cotte E,Beyer-Berjot L,Munoz-Bongrand N,Desfourneaux V,Rahili A,Duffas JP,Pautrat K,Denet C,Bridoux V,Meurette G,Faucheron JL,Loriau J,Guillon F,Vicaut E

    更新日期:2018-02-01 00:00:00

  • The role of immunosuppression in the efficacy of cancer gene therapy using adenovirus transfer of the herpes simplex thymidine kinase gene.

    abstract:OBJECTIVE:To determine whether the immune system limits or improves the therapeutic efficacy of an adenovirus vector expressing the herpes simplex thymidine kinase (HSVtk) gene in a subcutaneous tumor model. BACKGROUND DATA:Enhanced immune reactions against tumors may be therapeutically useful. However, recent studies...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199509000-00008

    authors: Elshami AA,Kucharczuk JC,Sterman DH,Smythe WR,Hwang HC,Amin KM,Litzky LA,Albelda SM,Kaiser LR

    更新日期:1995-09-01 00:00:00

  • Fibrin sealant versus mechanical stapling for mesh fixation during endoscopic extraperitoneal inguinal hernioplasty: a randomized prospective trial.

    abstract:OBJECTIVE:To compare the clinical outcome of simultaneous bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP) using fibrin sealant (FS) and mechanical stapling for prosthetic mesh fixation. SUMMARY BACKGROUND DATA:Similar efficacy of FS and mechanical stapling for mesh fixation has been demonstrat...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.sla.0000186440.02977.de

    authors: Lau H

    更新日期:2005-11-01 00:00:00

  • The international position on laparoscopic liver surgery: The Louisville Statement, 2008.

    abstract:OBJECTIVE:To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA:Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been...

    journal_title:Annals of surgery

    pub_type: 共识发展会议,杂志文章,实务指引

    doi:10.1097/sla.0b013e3181b3b2d8

    authors: Buell JF,Cherqui D,Geller DA,O'Rourke N,Iannitti D,Dagher I,Koffron AJ,Thomas M,Gayet B,Han HS,Wakabayashi G,Belli G,Kaneko H,Ker CG,Scatton O,Laurent A,Abdalla EK,Chaudhury P,Dutson E,Gamblin C,D'Angelica M,Nag

    更新日期:2009-11-01 00:00:00

  • Incidence and consequence of an hepatic artery injury in patients with postcholecystectomy bile duct strictures.

    abstract:OBJECTIVE:To compare the clinical presentation and results of treatment of postcholecystectomy bile duct injuries in patients with and without arterial injuries. SUMMARY BACKGROUND DATA:Incidence and impact of arterial injuries in patients with a postcholecystectomy biliary injury are unknown, although they are claime...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000074983.39297.c5

    authors: Alves A,Farges O,Nicolet J,Watrin T,Sauvanet A,Belghiti J

    更新日期:2003-07-01 00:00:00

  • Reconstruction for chronic dysfunction of ileoanal pouches.

    abstract:OBJECTIVE:A retrospective review was performed to determine the results after surgical reconstruction for chronic dysfunction of ileal pouch-anal procedures for ulcerative colitis and familial colonic polyposis at a university medical center. METHODS:During the 20-year period from 1978 to 1998, 601 patients underwent ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199902000-00006

    authors: Fonkalsrud EW,Bustorff-Silva J

    更新日期:1999-02-01 00:00:00

  • Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage.

    abstract:OBJECTIVE:To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. BACKGROUND:Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of surgery can lead to ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0b013e3181fd36a2

    authors: Eshuis WJ,van der Gaag NA,Rauws EA,van Eijck CH,Bruno MJ,Kuipers EJ,Coene PP,Kubben FJ,Gerritsen JJ,Greve JW,Gerhards MF,de Hingh IH,Klinkenbijl JH,Nio CY,de Castro SM,Busch OR,van Gulik TM,Bossuyt PM,Gouma DJ

    更新日期:2010-11-01 00:00:00

  • The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer.

    abstract:OBJECTIVE:The aim of this study was to show the safety and feasibility of single-port laparoscopic surgery (SPLS) by comparing its short-term outcomes with those following conventional laparoscopic surgery. SUMMARY BACKGROUND DATA:Single-port laparoscopic surgery maximizes the advantages of laparoscopic surgery, and t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318237826b

    authors: Kim SJ,Ryu GO,Choi BJ,Kim JG,Lee KJ,Lee SC,Oh ST

    更新日期:2011-12-01 00:00:00

  • Biliary reconstruction in right lobe living-donor liver transplantation: Comparison of different techniques in 321 recipients.

    abstract:OBJECTIVE:To assess the incidence of biliary complications after right lobe living-donor liver transplantation (LDLT) in patients undergoing duct-to-duct choledochocholedochostomy or Roux-en-Y choledochojejunostomy reconstruction. SUMMARY BACKGROUND DATA:Biliary tract complications remain one of the most serious morbi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000206419.65678.2e

    authors: Kasahara M,Egawa H,Takada Y,Oike F,Sakamoto S,Kiuchi T,Yazumi S,Shibata T,Tanaka K

    更新日期:2006-04-01 00:00:00

  • Physiologic role of cholecystokinin in the intestinal phase of pancreatic polypeptide release.

    abstract::Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous adminis...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198411000-00008

    authors: Fried GM,Ogden WD,Greeley GH Jr,Thompson JC

    更新日期:1984-11-01 00:00:00

  • The Linton splenorenal shunt in the management of the bleeding complications of portal hypertension.

    abstract::This report describes 140 cases in which Linton splenorenal shunts were performed for the management of the complications of portal hypertension by a large number of surgeons in a single hospital. There was a history of variceal bleeding in 130. Using the Childs designation to reflect hepatic functional reserve, the o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198212001-00008

    authors: Ottinger LW

    更新日期:1982-12-01 00:00:00

  • Magnetic resonance imaging versus computed tomography in the evaluation of soft tissue tumors of the extremities.

    abstract::Twenty patients with extremity soft tissue tumors were prospectively evaluated with magnetic resonance imaging (MRI) and computed tomography (CT) scans with subsequent anatomic correlation of surgical findings. MRI and CT had a similar percentage of accuracy in assessing tumor relationship with major neurovascular (80...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198704000-00002

    authors: Chang AE,Matory YL,Dwyer AJ,Hill SC,Girton ME,Steinberg SM,Knop RH,Frank JA,Hyams D,Doppman JL

    更新日期:1987-04-01 00:00:00

  • Prevention of surgical malpractice claims by use of a surgical safety checklist.

    abstract:OBJECTIVE:To assess what proportion of surgical malpractice claims might be prevented by the use of a surgical safety checklist. BACKGROUND:Surgical disciplines are overrepresented in the distribution of adverse events. The recently described multidisciplinary SURgical PAtient Safety System (SURPASS) checklist covers ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182068880

    authors: de Vries EN,Eikens-Jansen MP,Hamersma AM,Smorenburg SM,Gouma DJ,Boermeester MA

    更新日期:2011-03-01 00:00:00

  • Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma.

    abstract:OBJECTIVE:To analyze the yield and rate of node metastases (pN1) for prophylactic central (CND) and lateral neck dissection (LND) for papillary thyroid carcinoma, the risk factors for pN1, and outcomes. BACKGROUND:Prophylactic CND and LND are not routinely employed. Adjuvant radioiodine treatment may be modulated, how...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824b7b68

    authors: Hartl DM,Leboulleux S,Al Ghuzlan A,Baudin E,Chami L,Schlumberger M,Travagli JP

    更新日期:2012-04-01 00:00:00

  • Personal experience with 411 hepatic resections.

    abstract::Over a 24-year period, 411 partial hepatic resections were performed: 142 right or left trisegmentectomies, 158 lobectomies, 25 segmentectomies, and 86 local excisions. The operations were performed for benign lesions in 182 patients, for primary hepatic malignancies in 106, and for hepatic metastases in 123, includin...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198810000-00004

    authors: Iwatsuki S,Starzl TE

    更新日期:1988-10-01 00:00:00

  • Impact of neoadjuvant chemoradiation on lymph node status in esophageal cancer: post hoc analysis of a randomized controlled trial.

    abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000991

    authors: Robb WB,Dahan L,Mornex F,Maillard E,Thomas PA,Meunier B,Boige V,Pezet D,Le Brun-Ly V,Bosset JF,Mabrut JY,Triboulet JP,Bedenne L,Seitz JF,Mariette C,Fédération Française de Cancérologie Digestive, Société Française de Radiot

    更新日期:2015-05-01 00:00:00

  • Mucosal damage in the esophageal remnant after esophagectomy and gastric transposition.

    abstract:OBJECTIVE:To assess development of mucosal damage in the esophageal remnant in regard to the level of the esophagogastrostomy reconstruction either in a right chest or in a left neck position. SUMMARY BACKGROUND DATA:Esophagectomy with gastric interposition creates an in vivo human model of pathologic esophageal reflu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31818eec06

    authors: D'Journo XB,Martin J,Rakovich G,Brigand C,Gaboury L,Ferraro P,Duranceau A

    更新日期:2009-02-01 00:00:00