Kellett J G, O'Riordan J
MD Comput. 1992 May-Jun;9(3):157-64, 180.
We constructed a decision analysis model based on data in the medical literature to estimate the possible outcomes of thrombolytic therapy in patients 50 to 80 years old with possible myocardial infarction. We used the model to test the most likely effects of treatment (determined by averaging the values in reports of large studies) and the worst effects reported so far. The program begins by asking the patient's age, the hours from the onset of pain, and the probability of acute myocardial infarction. It then provides an opportunity to perform sensitivity analyses by changing the values for these variables and for the probability of death in the absence of thrombolytic therapy, as well as for the probability of major stroke and hemorrhage. The counterintuitive findings observed with this program are that the benefits of thrombolytic therapy increase with age and that young patients derive surprisingly little benefit from it.
我们基于医学文献中的数据构建了一个决策分析模型，以估计年龄在50至80岁、可能发生心肌梗死的患者进行溶栓治疗的可能结果。我们使用该模型来测试治疗的最可能效果（通过对大型研究报告中的数值进行平均得出）以及迄今为止报告的最差效果。该程序首先询问患者的年龄、疼痛发作后的小时数以及急性心肌梗死的概率。然后，它提供了一个机会，通过改变这些变量的值以及在不进行溶栓治疗时的死亡概率、重大中风和出血的概率来进行敏感性分析。通过该程序观察到的违反直觉的发现是，溶栓治疗的益处随年龄增加，而年轻患者从中获得的益处出奇地少。
