Graphical representation of life paths to better convey results of decision models to patients

Med Decis Making. 2015 Apr;35(3):398-402. doi: 10.1177/0272989X14565822. Epub 2015 Jan 14.

Abstract

The inclusion of patients' perspectives in clinical practice has become an important matter for health professionals, in view of the increasing attention to patient-centered care. In this regard, this report illustrates a method for developing a visual aid that supports the physician in the process of informing patients about a critical decisional problem. In particular, we focused on interpretation of the results of decision trees embedding Markov models implemented with the commercial tool TreeAge Pro. Starting from patient-level simulations and exploiting some advanced functionalities of TreeAge Pro, we combined results to produce a novel graphical output that represents the distributions of outcomes over the lifetime for the different decision options, thus becoming a more informative decision support in a context of shared decision making. The training example used to illustrate the method is a decision tree for thromboembolism risk prevention in patients with nonvalvular atrial fibrillation.

Keywords: Markov models; Monte Carlo simulation; risk communication; shared decision-making; time-based reporting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / drug therapy
  • Decision Making*
  • Decision Trees*
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Markov Chains*
  • Patient Participation / methods*
  • Physician-Patient Relations
  • Time Factors

Substances

  • Fibrinolytic Agents