Use of decision analysis in a family practice residency for a patient with an abdominal aortic aneurysm.

BACKGROUND: A patient at the Tatem-Brown Family Practice Center with many medical problems asked for advice about elective surgical resection of a large abdominal aortic aneurysm. METHODS: The best course of action was not obvious, so a decision tree was constructed using data from the medical literature and the patient's rating of several quality of life issues. RESULTS: Elective surgery was the optimal choice for this patient, but the decision was sensitive to values chosen for two variables in the decision model. CONCLUSION: Decision analysis has benefits in a family practice residency. Residents become familiar with vigorous literature review and decision-analytic tools and principles. They gain a deeper knowledge of the patient, due to the need to understand the patient's relative values for potential outcomes of medical intervention.