Reanalysis of Unruptured Intracranial Aneurysm Management: Effect of a New International Study on the Threshold Probabilities

Abstract

Annual UN-AN rupture rate and the utility for knowingly living with UN-AN are key factors when deciding on a therapeutic strategy. Also, updating published decision analyses can improve clinical decision making by integrating clinical judgment and newly available clinical data.

Prediction model for 3‐year rupture risk of unruptured cerebral aneurysms in Japanese patients

“…In making this decision we also account for patient preference, medical personnel expertise, environment, cost, and other factors. The ability to quantify rupture risk using the best available evidence is the first step to achieve this end . Our results would make it possible to guide patients and medical personnel through the complex web of relevant factors.…”

Cost-effectiveness of preventive treatment of intracranial aneurysms

“…Several such decision and cost-effectiveness analyses have been performed. [7][8][9][10][11] However, in these analyses, comparisons among surgical clipping, endovascular coiling, and no treatment were based on earlier estimates of complications risks or data derived from the ISUIA only. 4 Furthermore, the risk of formation and rupture of recurrent and de novo aneurysms were not included in these models.…”

Cost-Effectiveness Analysis of Telemedicine to Evaluate Diabetic Retinopathy in a Prison Population

“…Although minorities tend to have higher reported rates of retinopathy, such data are not included because we could not identify well-stratified reports for sex, ethnicity, and age. Second, due to rapid progress in the field of medical information technology, new information may be now available (36). Continuous updates based on new information could be important because this is a prospective analysis.…”