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《Data, Models and Decisions》Practice 1 About James McGill’s brain tumor  

2008-05-10 16:14:02|  分类: 默认分类 |  标签: |举报 |字号 订阅

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PROBLEM:

James McGill’s, age 68, was recently diagnosed with a particular type of brain tumor(瘤), and was referred to Dr.Mitchell Zylber, chief of surgery at the university hospital, for further evaluation . This type of tumor is benign(良性) in 50% of cases and is malignant(恶性) in the other 50% of cases.

James McGill’s remaining lifetime will depend on the type of tumor(benign or malignant) and on the decision whether or or not to remove the tumor. Table 1.7 shows estimates of James McGill’s remaining lifetime according to the most up-to-date information known about this type of tumor.

Dr.Mitchell Zylber could perform exploratory surgery prior to the decision whether or not to remove the tumor, in order to better assess the status of the tumor. Exploratory surgery  is known to indicate a benign tumor 75% of the time, if the tumor is indeed benign. The surgery is known to indicate a malignant tumor 65% of the time, if the tumor is indeed malignant.

Exploratory surgery is dangerous: there is a 5% chance that patients with profiles like James McGill’s will not survive such surgery due to complications from anesthesia(麻醉), ets.

If no exploratory surgery be performed, James McGill must decide whether or not to have the tumor removed. And if exploratory surgery is performed, James must decide whether or not to have the tumor removed on the results of the exploratory surgery.

 

QUESTION:

1. Draw the decision tree for this problem

2. What probabilities need to be computed in order to solve the decision tree.

3. James McGill’s children are expected to have children of own within the next two or three years. Suppose James McGill wants to maximize the probability that he will live to see his grandchildren. How should this affect his decision strategy?

4. What ethical (伦理的) questions does this medical problem pose?

  

  建议思路:

1、  乐观估计与处置方案

2、  悲观估计与处置方案

3、  以或者看到孙子为主要目标

4、  如果脑瘤摘除术的安全性降低,从100%--35%,情况会有那些变化(决策的灵敏度分析)

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