Steven G Pauker

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The choice between coronary by-pass surgery and medical therapy in patients with angiographically documented coronary artery disease was examined. This decision analysis included consideration of patient preferences, severity of disease, prognosis with medical therapy, surgical mortality rate, graft patency rate, the probability that surgery will provide(More)
The availability of vidarabine for the therapy of suspected herpes simplex encephalitis presents a difficult decision for a physician as to whether to do brain biopsy, to treat blindly, or to withhold specific therapy in a patient. The choice is made more difficult because the physician must weigh four likelihoods simultaneously: namely, of the disease, of(More)
Although clinical trials often provide "best evidence" comparing the effectiveness of alternative management strategies, such evidence can be limited in duration or in the results reported, causing clinicians and policy analysts to wonder "what if?" Models of the clinical prognosis-often spanning patients' lifetimes (the "long haul")-are perhaps weaker(More)
TO THE EDITOR: The recent changes to the U.S. Preventive Services Task Force (USPSTF) breast cancer screening recommendations are welcome and reflect the best available current evidence (1). The updated systematic review by Nelson and colleagues (2), which is the basis for the changes, concurs substantially with the relevant Cochrane review on mammography(More)
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