EDITORIAL

Decision analysis

Whose lung is it anyway?

T Treasure

Department of Thoracic Surgery, Guy's Hospital, London SE1 9RT, UK

Correspondence to:
Correspondence to:
Professor T Treasure

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Should the decision to operate be made by patients with NSCLC or their doctors?

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Keywords: lung cancer; decision analysis

The central point of the argument in the paper by Dowie and Wildman in this issue of Thorax¹ is that it is the patient, not the doctors, who should decide whether to take the risk of an operation in the hope of curing lung cancer. I agree, and I know from working with a number of chest physicians on a regular basis that the patient's preference is genuinely central in decisions made about treatment. What is less certain is whether the choices being made are as explicit and as fully informed as would be necessary to implement decision analysis as espoused in this paper.² My purpose is to ground the ideas in the context of current clinical practice and to see how near or far we are from patient determined decision making.

Firstly, the diagnosis must be known—including stage and cell type—and an estimate of prognosis made before . . . [Full text of this article]

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This article has been cited by other articles:

• Tan, C., Treasure, T., Browne, J., Utley, M., Davies, C. W H, Hemingway, H. (2007). Seeking consensus by formal methods: a health warning. JRSM 100: 10-14 [Full Text]  
• Berrisford, R., Brunelli, A., Rocco, G., Treasure, T., Utley, M., On behalf of the Audit and guidelines committee of, (2005). The European Thoracic Surgery Database project: modelling the risk of in-hospital death following lung resection. Eur. J. Cardiothorac. Surg. 28: 306-311 [Abstract] [Full Text]  
• Treasure, T. (2005). Mortality in adult cardiac surgery. BMJ 330: 489-490 [Full Text]  
• Tekkis, P. P, Poloniecki, J. D, Thompson, M. R, Stamatakis, J. D (2003). Operative mortality in colorectal cancer: prospective national study. BMJ 327: 1196-1201 [Abstract] [Full Text]  
• Treasure, T., Utley, M., Bailey, A. (2003). Assessment of whether in-hospital mortality for lobectomy is a useful standard for the quality of lung cancer surgery: retrospective study. BMJ 327: 73- [Abstract] [Full Text]  
• Macbeth, F, Dowie, J, Wildman, M (2002). Decision analysis in NSCLC. Thorax 57 : 919-920 [Full Text]