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Decision Analysis in the Evaluation of Revascularization

Rolf M. Gunnar, MD
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Loyola University Medical Center
May wood, IL 60513

Ann Intern Med. 1990;113(11):817-818. doi:10.7326/0003-4819-113-11-817
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In this issue, Dr. Wong and colleagues (1) evaluate the effects of revascularization for chronic stable angina, using a mathematical model to simulate clinical strategies. The model, however, is only as good as the database. A great deal of uncontrolled data on the outcome of patients treated with percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft surgery (CABG) are available. Reliable information about the natural history of angina pectoris without mechanical intervention, however, is difficult to find.

Wong and colleagues (1) rely quite heavily on data from the Coronary Artery Surgery Study (CASS) (2) as well as on


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