Lucidarme O, Poisson-Salomon A S, Durand-Zaleski I, Gruner M, Montagne J P
Service de l'évaluation, DPIM, Paris.
J Radiol. 1995 Jun;76(6):359-63.
To assess the advantages of systématic herniography in cases of unilateral inguinal hernia in infants.
Decision analysis presented in the first part of this article was used. A preliminary retrospective study of 348 cases as well as a literature review were utilized to determine the probabilities required in order to create and run the decision aid algorithm. Gonadic benefit was used as the health indicator.
For males, gonadic benefit procured by the herniography depends on the risk of strangulation in cases of groin hernia and on the frequency of testicular atrophy after inguinal hernioplasty. The evaluation of these two elements largely determines the choice of medical and surgical practices. For a 0.44% risk of post-operative testicular atrophy and a risk of strangulated hernia estimated at 20%, the cost-effectiveness ratio is FF, 199681 to save a testicle. One testicle is saved every 455 herniographies, with 24 possible post-examination complications. For female, herniography provides no gonadic benefit.
Decision analysis permits the quantification of results, leading to improved clinical judgement and facilitating the evaluation of medical practice.
评估系统性疝造影术在婴儿单侧腹股沟疝病例中的优势。
采用本文第一部分所呈现的决策分析方法。利用对348例病例的初步回顾性研究以及文献综述来确定创建和运行决策辅助算法所需的概率。将性腺益处用作健康指标。
对于男性，疝造影术所获得的性腺益处取决于腹股沟疝绞窄的风险以及腹股沟疝修补术后睾丸萎缩的发生率。对这两个因素的评估在很大程度上决定了医疗和手术方式的选择。对于术后睾丸萎缩风险为0.44%且绞窄性疝风险估计为20%的情况，挽救一个睾丸的成本效益比为199681法国法郎。每进行455次疝造影术可挽救一个睾丸，检查后可能出现24种并发症。对于女性，疝造影术未提供性腺益处。
决策分析能够对结果进行量化，从而改善临床判断并有助于评估医疗实践。
