Each year 21,000 of these individuals suffer a subarachnoid hemorrhage, resulting in significant morbidity, mortality, and expense.
Neurosurgeons make final decisions regarding operative intervention for aneurysm patients.
While there is a growing body of data on the natural history, management, and outcomes of cerebral aneurysms, the components of neurosurgical decision-making for aneurysm patients are poorly understood. My immediate goal is to develop a decision analytic and cost-effectiveness computer simulation model to evaluate the outcomes of neurosurgical decisions in patients with cerebral aneurysmsal disease. The research component will accomplish these aims via primary collection of patient preference and economic data, secondary data analysis, and mathematical modeling techniques. The proposal will update and greatly expand the my preliminary model to incorporate both unruptured and ruptured aneurysms, actual patient preferences for various outcome states, disease severity-adjustment, recent advances in the understanding of aneurysm natural history, the evolution of treatment technologies, and more detailed economic data. In addition, I will expand my skills and expertise in formal decision sciences and cost-effectiveness analysis through mentored sessions, specific courses, seminars, directed readings, and research work.