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Markov models are useful when a decision problem involves risk that is continuous over time, when the timing of events is important, and when important events may happen more than once. Representing such clinical settings with conventional decision trees is difficult and may require unrealistic simplifying assumptions. Markov models assume that a patient is(More)
We examined geographic variation in the rate of inappropriate hospitalization and the effect of cost sharing on that rate. The medical records of 1132 adults hospitalized in a randomized trial of health insurance plans were reviewed by two physicians who were blinded to the patients' insurance plan. They judged 23 percent of the admissions to be(More)
No prospective, randomized clinical trial comparing coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, and conservative therapy has been reported. To address when revascularization is indicated, we constructed a decision analytic model. Our model incorporates procedure-related mortality and morbidity, coronary artery(More)
BACKGROUND This guideline focuses on long-term administration of antithrombotic drugs designed for primary and secondary prevention of cardiovascular disease, including two new antiplatelet therapies. METHODS The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis(More)
The implantable cardioverter-defibrillator (ICD) greatly reduces the incidence of sudden cardiac death among patients with recurrent sustained ventricular tachycardia and fibrillation who do not respond to conventional antiarrhythmic therapy. A cost-effectiveness analysis was performed, comparing the ICD, amiodarone and conventional agents. Actual variable(More)
BACKGROUND Patients infected with HIV value both longevity and health. OBJECTIVE To understand how HIV-infected patients value their health. DESIGN Interview study. SETTING Regional treatment center for HIV. PATIENTS 51 patients with HIV infection. MEASUREMENTS Life-satisfaction, health rating, time-tradeoff, and standard-gamble scores. RESULTS(More)
This paper presents a framework for a peer review process for medical decision analysis models. This framework is based on the collective experience of the members of the Inter-PORT Decision Modeling work group, a team of decision analysis experts comprising members from each of the Patient Outcomes Research Teams (PORTs), sponsored by the Agency for Health(More)
OBJECTIVES This article provides recommendations on the use of antithrombotic therapy in patients with stroke or transient ischemic attack (TIA). METHODS We generated treatment recommendations (Grade 1) and suggestions (Grade 2) based on high (A), moderate (B), and low (C) quality evidence. RESULTS In patients with acute ischemic stroke, we recommend IV(More)
Existing text-based clinical practice guidelines can be difficult to put into practice. While a growing number of such documents have gained acceptance in the medical community and contain a wealth of valuable information, the time required to digest them is substantial. Yet the expressive power, subtlety and flexibility of natural language pose challenges(More)
OBJECTIVE The purpose of this study was to examine implications of increased perfect use on the cost-effectiveness of the contraceptive patch compared with combination oral contraceptives (COCs). STUDY DESIGN This study compared the patch with low-estrogen-dose COCs. It assumes that the risks of developing a medical condition during use are the same for(More)