Decision Tree

Take your decision tree and boil it back down to 1 central decision, that must be made.

To test or not to test, to cut or not to cut, to treat or to wait

Every possible reasonable response should be pursued

Justify every numerical assumption with a reference (prevalence, test performance, complication/mortality rates, etc.)

Participation

You are graded on the board for questions and comments

Ask and critique

Utility

Formal utility exercise using one of the methodologies from utility theory

o Something that produces a clear categorical ranking of outcome

o Health 10

o Life w/mild disability 6

o Life w/severe disability 3

o Death - 1

the difference between each of these levels is actually proportional based upon the real utility and that's what utility theory.

Find out prior & posterior probability

Patient presents with weling and pain in ano and physician on this Whion as a pow Deep en Thrombosis (DVTI Step 1 - very specific question that you have selected. (Patient presents, has symptoms like DVT, you can treat presumptively, await test confirmation, or do nothing... which is usually cooptable, but be useful to show what will happen if you do nothing or the atient refuses) 208 Administrato Norwerven. Observe Din Step 2 - set up a tree with a very pathway's steps. One of my personal practices is to use right/wrong or disease - as 1st step of every branch *** (using prevalence and what we know about the predictive strength of the evaluation), * In testing branches, remember that success and failure look different, because we actually know something that we don't know in the other branches... No DVT the result of the test, 1) the p(D+) is actually the p(DIT) si 2) if you stack tests you need to keep updating the running P( DT) after each preceding test Damer ser (6) spesso pwelling 41% (71 OVT Suwe Die Chance Chance . $0.9031 9.15 test Tes. Chase NO AR AE 0 Chance (1) 07 4 ser rasonography Spec swing 4147 Norverton 1 0 No DVT 800 - Ha DVT Chan 0.0% Test Chance Test (71 4157 redited ved any of the outcomes comptable and that this mod would have a utility of My reasoning is that they end up having a negative outcome because the physician decided to wait to do a lethal weldd be a unacceptable amour 11 Adrier Aricca 67 NO Werve ( 754 - Pulmonary Charce Embdin 1 Nop Bubolism NO bollam 754 Pintonary Charts Esben ese ( 4o. Burve 6041 40 (4) Chande Step 3. be careful to keep you treatment steps consistent in each branch. con if same treatment isi caci branch, it has same complication rates and outcomes 38 30.0 0.18 1 Burve Burvive Die Chance Chance MAE VE Change 771 33921 33% (27 982 ( Assumptions ange of percentage was given the lowest percentage was presented 03 77 1 50 Complications Charo NO Complications No Cornications Coniplications Chance o 0 1 0 Citations SON (5) SOS (5 1 1 0 Step 4 - use any one of the utility theory methods (le, standard gamble) to establish the utilities with good resolution *** make sure all outcomes are represented and the utilities represent actual amount of increased utility (eg, I prefer x 40% for than y) 1. PAG.Nguyen TN.Cls, D. Labreche, M. Honda Fani & Olaber, 2011) Alcoagulationsdated were drug events The Aurel of medicine 124(12) 1136 1142 2 Hot A. Siverten M D M D N. Petterson TM Fallon WM & Mekon L (1909 Predictors of surwaardeep ven thrombola and pulmonary embol a population based cohort shuty Archives of intema medidne 16.445.453 3. Linkin LA.Cholt & Doulos D. (2000). Clinical impact of bleeding in patients taking oral accograpy for venous omboembo a meta-analysis. Annals of Wernd medicine 139611). 891-900 WII. San (2012) Dlagross of deep venous tribos and pulmonary embolan American any physician 8 10 913-010 S. NON. EA Van der Halle 1 Den Exer, LLAM. Human M V. & Konsts 2014. The post FE syndrome a new concepe for choic conditions of putinary emboll Bood news 2016) 221020 6. M. CL Legnare. Favaretto, E. Vakre L Goca - Parc G. (2012). The Wells rule and Damer for the sages of scaled a deep van tombols. Journal of tombols and remonts 10/111 2264-228 7. Anand... Wells. Hun D. Bil Edwards P. Cock D. & Grabara (1998] Does this posters have deep wells thrombos Lama 27914). 1094-1099 & Cervers for Disease Control and Prevention (2020). Data and state on venous thromboembols Goodacre S. Sampson F. Thones, S. von Beek. E. & Button. A 20051 Systematic review and analysis of the diagnostic Acouracy of rasonography for deep veln thrombosis BNC medical maging in 1.13 Patient presents with weling and pain in ano and physician on this Whion as a pow Deep en Thrombosis (DVTI Step 1 - very specific question that you have selected. (Patient presents, has symptoms like DVT, you can treat presumptively, await test confirmation, or do nothing... which is usually cooptable, but be useful to show what will happen if you do nothing or the atient refuses) 208 Administrato Norwerven. Observe Din Step 2 - set up a tree with a very pathway's steps. One of my personal practices is to use right/wrong or disease - as 1st step of every branch *** (using prevalence and what we know about the predictive strength of the evaluation), * In testing branches, remember that success and failure look different, because we actually know something that we don't know in the other branches... No DVT the result of the test, 1) the p(D+) is actually the p(DIT) si 2) if you stack tests you need to keep updating the running P( DT) after each preceding test Damer ser (6) spesso pwelling 41% (71 OVT Suwe Die Chance Chance . $0.9031 9.15 test Tes. Chase NO AR AE 0 Chance (1) 07 4 ser rasonography Spec swing 4147 Norverton 1 0 No DVT 800 - Ha DVT Chan 0.0% Test Chance Test (71 4157 redited ved any of the outcomes comptable and that this mod would have a utility of My reasoning is that they end up having a negative outcome because the physician decided to wait to do a lethal weldd be a unacceptable amour 11 Adrier Aricca 67 NO Werve ( 754 - Pulmonary Charce Embdin 1 Nop Bubolism NO bollam 754 Pintonary Charts Esben ese ( 4o. Burve 6041 40 (4) Chande Step 3. be careful to keep you treatment steps consistent in each branch. con if same treatment isi caci branch, it has same complication rates and outcomes 38 30.0 0.18 1 Burve Burvive Die Chance Chance MAE VE Change 771 33921 33% (27 982 ( Assumptions ange of percentage was given the lowest percentage was presented 03 77 1 50 Complications Charo NO Complications No Cornications Coniplications Chance o 0 1 0 Citations SON (5) SOS (5 1 1 0 Step 4 - use any one of the utility theory methods (le, standard gamble) to establish the utilities with good resolution *** make sure all outcomes are represented and the utilities represent actual amount of increased utility (eg, I prefer x 40% for than y) 1. PAG.Nguyen TN.Cls, D. Labreche, M. Honda Fani & Olaber, 2011) Alcoagulationsdated were drug events The Aurel of medicine 124(12) 1136 1142 2 Hot A. Siverten M D M D N. Petterson TM Fallon WM & Mekon L (1909 Predictors of surwaardeep ven thrombola and pulmonary embol a population based cohort shuty Archives of intema medidne 16.445.453 3. Linkin LA.Cholt & Doulos D. (2000). Clinical impact of bleeding in patients taking oral accograpy for venous omboembo a meta-analysis. Annals of Wernd medicine 139611). 891-900 WII. San (2012) Dlagross of deep venous tribos and pulmonary embolan American any physician 8 10 913-010 S. NON. EA Van der Halle 1 Den Exer, LLAM. Human M V. & Konsts 2014. The post FE syndrome a new concepe for choic conditions of putinary emboll Bood news 2016) 221020 6. M. CL Legnare. Favaretto, E. Vakre L Goca - Parc G. (2012). The Wells rule and Damer for the sages of scaled a deep van tombols. Journal of tombols and remonts 10/111 2264-228 7. Anand... Wells. Hun D. Bil Edwards P. Cock D. & Grabara (1998] Does this posters have deep wells thrombos Lama 27914). 1094-1099 & Cervers for Disease Control and Prevention (2020). Data and state on venous thromboembols Goodacre S. Sampson F. Thones, S. von Beek. E. & Button. A 20051 Systematic review and analysis of the diagnostic Acouracy of rasonography for deep veln thrombosis BNC medical maging in 1.13