Use of decision analysis in a family practice residency for a patient with an abdominal aortic aneurysm.

BACKGROUND

A patient at the Tatem-Brown Family Practice Center with many medical problems asked for advice about elective surgical resection of a large abdominal aortic aneurysm.

METHODS

The best course of action was not obvious, so a decision tree was constructed using data from the medical literature and the patient's rating of several quality of life issues.

RESULTS

Elective surgery was the optimal choice for this patient, but the decision was sensitive to values chosen for two variables in the decision model.

CONCLUSION

Decision analysis has benefits in a family practice residency. Residents become familiar with vigorous literature review and decision-analytic tools and principles. They gain a deeper knowledge of the patient, due to the need to understand the patient's relative values for potential outcomes of medical intervention.