Decision Analysis and Coronary Artery Surgery

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Abstract
Dr. Pauker has attempted to organize the results of studies on proper selection of patients for surgery to develop a decision analysis approach to the management of an individual with coronary artery disease. Organization of the approach to aid in the process of making the best decision in any clinical situation is highly desirable and should be studied by all physicians. Dr. Pauker has attempted to establish a model on the basis of published reports obtained by surgical and nonsurgical therapy as related to the severity of the obstructive coronary disease and impaired left ventricular function evaluated by the ejection fraction. These studies have provided important epidemiologic information, but generalizations cannot be applied to an individual patient with obstructive coronary disease. The variables involved in the selection of patients for bypass surgery are far greater than these two.

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