Academia and Clinic

Cost-Effectiveness of Alternative Management Strategies for Patients with Solitary Pulmonary Nodules

Appendix (Figure 2). Needle biopsy may result in fatal or nonfatal complications or no complications (biopsy subtree). If no fatal complications occur, the biopsy may be diagnostic or nondiagnostic, depending on whether it yields a specific malignant or benign diagnosis. If the biopsy reveals malignancy, we assumed that surgery would be performed. If the biopsy reveals a specific benign diagnosis, we assumed that the patient would be treated accordingly and monitored with serial chest radiographs. After a nondiagnostic biopsy, surgery or observation may be selected as the next diagnostic option. Surgery may result in fatal or nonfatal complications, or no complication (surgery subtree). At surgery, most malignant nodules will be local-stage lung cancer, but metastases to regional lymph nodes may be detected in some cases. Some nodules will be benign, depending on the prevalence of benign disease in the target population. Decision model subtrees.