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Charles E. Kahn, Jr, MD; Peter Haddawy, PhD
Milwaukee, Wis

Arch Intern Med. 1995;155(4):426.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In the course of developing a new technique for medical decision making, we used the data from an article that appeared in the ARCHIVES¹ as the basis for a decision model. Our results did not agree with the published results¹ for several of the management strategies. For example, our software (and decision trees drawn by hand) indicated that the expected cost of strategy A ("No tests or treatment") was $1905, not $2220 as published. Our decision-tree representation of strategy A (Figure 1) and one that explains the study¹ results (Figure 2) are enclosed.

The mortality and cost of several other strategies differ from our calculations as well. In fact, our analysis, which evaluated a superset of the 24 strategies evaluated by Hillner et al¹ showed that, with the article's "standard model" assumptions, the most cost-effective management strategy is not strategy I ("If real-time ultrasonography [RUS] suggests deep . . . [Full Text PDF of this Article]

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