PROBLEMS AND PERSPECTIVES ON THE USE OF DECISION-ANALYSIS MODELS FOR PROSTATE-CANCER

The use of modeling studies to illustrate the impact of decision choic es in cancer treatment is becoming increasingly common. Decision maker s should have some understanding of modeling terminology and issues to evaluate such studies. To be useful, prostate cancer treatment models must be based on acceptable structural assumptions, contain valid dat a and be understandable to clinical experts. Assumptions with regard t o population age, clinical stage, tumor differentiation and combinatio ns of treatment modalities used initially, and for later management of local relapse and distant metastases must all be considered. Difficul ties abound because most data sources need some adjustment to avoid bi as or to reflect current practice. Despite these difficulties, modelin g studies may provide unique insights that are valuable for improving prostate cancer decision making.