A comparison of treatment strategies for hypoplastic left heart syndrome using decision analysis
| Autor: | Richard E. Chinnock, Pamela C Jenkins, Kathy J. Jenkins, Robert N. Vincent, Charles E. Canter, Michael F. Flanagan, Anna N. A. Tosteson, Gerald T. O'Connor, James D. Sargent |
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| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
Heart disease Waiting Lists business.industry Palliative Care Infant medicine.disease Sensitivity and Specificity Hypoplasia Surgery Hypoplastic left heart syndrome Decision Support Techniques Transplantation Hypoplastic Left Heart Syndrome Medicine Treatment strategy Heart Transplantation Humans Organ donation Stage (cooking) business Cardiology and Cardiovascular Medicine Decision analysis |
| Zdroj: | Journal of the American College of Cardiology. 38(4):1181-1187 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(01)01505-4 |
| Popis: | OBJECTIVESWe sought to identify the optimal treatment strategy for hypoplastic left heart syndrome (HLHS).BACKGROUNDSurgical treatment of HLHS involves either transplantation (Tx) or staged palliation of the native heart. Identifying the best treatment for HLHS requires integrating individual patient risk factors and center-specific data.METHODSDecision analysis is a modeling technique used to compare six strategies: staged surgery; Tx; stage 1 surgery as an interim to Tx; and listing for transplant for one, two, or three months before performing staged surgery if a donor is unavailable. Probabilities were derived from current literature and a dataset of 231 patients with HLHS born between 1989 and 1994. The goal was to maximize first-year survival.RESULTSIf a donor is available within one month, Tx is the optimal choice, given baseline probabilities; if no donor is found by the end of one month, stage 1 surgery should be performed. When survival and organ donation probabilities were varied, staged surgery was the optimal choice for centers with organ donation rates |
| Databáze: | OpenAIRE |
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