1
40
2
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1177/0272989x9801800210" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/0272989x9801800210</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
213-219
Issue
2
Volume
18
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Treatment of early-stage breast cancer in the elderly: A health-outcome-based approach
Publisher
An entity responsible for making the resource available
Medical Decision Making
Date
A point or period of time associated with an event in the lifecycle of the resource
1998
1998-04
Subject
The topic of the resource
breast-cancer; Health Care Sciences & Services; follow-up; women; recurrence; clinical-trial; radiation-therapy; Medical Informatics; conservative surgery; adjuvant tamoxifen; comparing total mastectomy; lumpectomy; Markov processes; modified radical-mastectomy; outcomes analysis
Creator
An entity primarily responsible for making the resource
Carter K J; Ritchey N P; Castro F; Caccamo L P; Kessler E; Erickson B A; Gawdyda L M
Description
An account of the resource
Purpose. To evaluate the post-lumpectomy treatment of a nonpalpable, stage 1, T1b tumor, mammographically detected, in a 74-year-old woman without comorbidities. Methods. A Markov process, through 120 monthly cycles, was used to model patient progression through a treatment program, employing literature data and a health-outcome utility. Treatments considered were: observation; radiation totaling 5,000 cGy over six weeks; tamoxifen, 20 mg/day, for five years; simple mastectomy; and radiation therapy plus tamoxifen. Health states included absence of disease (NED), loco-regional recurrence, distant metastasis, age-sex-race (ASR)-adjusted death, cancer mortality, treatment complications, and post-mastectomy death. Transition probabilities were established from the literature. Health-state utilities were determined from the responses of health care professionals to a basic reference gamble. Results. Quality-adjusted life years (QALYs) were determined to be 8.19 for radiation plus tamoxifen, decreasing to 8.04 for mastectomy, a difference of only a 0.15 years (1.8 months). Sensitivity analysis, however, showed relative stability in the ranking among treatment options. Conclusion. Although the model showed little difference between QALYs with the treatments, the combination of radiation and tamoxifen provides the optimal therapy for this case.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/0272989x9801800210" target="_blank" rel="noreferrer noopener">10.1177/0272989x9801800210</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article or Conference Abstract Publication
1998
adjuvant tamoxifen
breast-cancer
Caccamo L P
Carter K J
Castro F
clinical-trial
comparing total mastectomy
conservative surgery
Erickson B A
Follow-up
Gawdyda L M
Health Care Sciences & Services
Journal Article or Conference Abstract Publication
Kessler E
Lumpectomy
Markov processes
Medical Decision Making
Medical Informatics
modified radical-mastectomy
outcomes analysis
radiation-therapy
Recurrence
Ritchey N P
Women
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1177/0272989x9901900107" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/0272989x9901900107</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
49-57
Issue
1
Volume
19
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Analysis of three decision-making methods: A Breast cancer patient as a model
Publisher
An entity responsible for making the resource available
Medical Decision Making
Date
A point or period of time associated with an event in the lifecycle of the resource
1999
1999-01
Subject
The topic of the resource
breast-cancer; Health Care Sciences & Services; clinical-trial; radiation-therapy; Medical Informatics; mastectomy; conservative surgery; stage-i; adjuvant tamoxifen; analytic; analytic hierarchy process; Markov process; network process
Creator
An entity primarily responsible for making the resource
Carter K J; Ritchey N P; Castro F; Caccamo L P; Kessler E; Erickson B A
Description
An account of the resource
Purpose: To compare three decision making techniques using a common clinical problem. Methods: Two recently developed methods, the analytic hierarchy process (AHP) and the analytic network process (ANP), were compared with a Markov process in the evaluation of the optimal post-lumpectomy treatment strategy for an elderly woman with a mammographically detected, nonpalpable early-stage breast cancer. The following treatment alternatives were considered: observation, radiation, tamoxifen, combination radiation and tamoxifen, and simple mastectomy. All three decision methods incorporated patient preferences. Results: The models agreed on the ranking of the preferred treatment, radiation and tamoxifen, but there were variations in the rankings of the other treatment choices. Individual differences between the three models were uncovered. The Markov process provided estimates of quality-adjusted life expectancy and distribution of health events. Both AHP and ANP required less development time than the Markov process. Conclusion: All three methods may be useful tools to the clinician in analyzing complex medical problems. The Markov is the most labor-intensive method but provides detailed results, whereas the AHP and the ANP give only rank orders of the alternatives. The most important considerations in choosing between these methods are time to project completion and the detail of information sought.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/0272989x9901900107" target="_blank" rel="noreferrer noopener">10.1177/0272989x9901900107</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article or Conference Abstract Publication
1999
adjuvant tamoxifen
analytic
analytic hierarchy process
breast-cancer
Caccamo L P
Carter K J
Castro F
clinical-trial
conservative surgery
Erickson B A
Health Care Sciences & Services
Journal Article or Conference Abstract Publication
Kessler E
Markov process
Mastectomy
Medical Decision Making
Medical Informatics
network process
radiation-therapy
Ritchey N P
stage-i