Question
A 66-year-old man has an inguinal hernia. His internist says he should wear a truss, which will hold the hernia in and thereby avoid the
A 66-year-old man has an inguinal hernia. His internist says he should wear a truss, which will hold the hernia in and thereby avoid the risk of operation. The patient has been wearing the truss. It is not painful, but when he goes to his friend's swimming pool he is embarrassed by it. To avoid the embarrassment, he decides to be admitted for surgery. According to the anesthesiologist, if the patient wears a truss there is a 97% chance of living out the rest of his life without having the hernia strangulate. There is a 3% chance of strangulation, however. If strangulation occurs, there will be an emergency operation that has a 15% operative mortality. This patient is expected to live eight more years. The emergency operative mortality would on the average be expected to shorten his life to four years. This is because strangulation is assumed to occur halfway through his expected lifetime. If the patient chooses the elective surgery, he faces a 5% operative mortality with a loss of eight years of life and a 95% chance of surviving the operation and living out his remaining eight years. Perform a decision tree analysis to determine what the patient should do.
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