HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Holloway, R. G. Articles by Mushlin, A. I. Search for Related Content PubMed PubMed Citation Articles by Holloway, R. G. Articles by Mushlin, A. I.

Intracranial mass lesions in acquired immunodeficiency syndrome

Using decision analysis to determine the effectiveness of stereotactic brain biopsy

From the Department of Neurology (Dr. Holloway), Community and Preventive Medicine (Drs. Holloway and Mushlin), and Medicine (Dr. Mushlin), University of Rochester School of Medicine and Dentistry, Rochester, NY.
Supported by PHS Award, grant no. 1 T32 HS00044-03 (R.G.H.).
Received March 21, 1995. Accepted in final form August 10, 1995.
Address correspondence and reprint requests to Dr Holloway, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 644, Rochester, NY 14642.

We studied the effectiveness of performing a stereotactic brain biopsy in the individual with acquired immunodeficiency syndrome (AIDS) and an intracranial mass lesion who failed 2 weeks of antitoxoplasmosis therapy.We used a decision analysis to compare two different treatment strategies: biopsy and no biopsy. The analysis estimates the average life expectancy for each choice and investigates the sensitivity of these results by varying parameters within the model. In the base case analysis (diagnostic yield of biopsy, 0.89; operative mortality, 0.015; life expectancy of lymphoma untreated and treated, 42 and 120 days), the life expectancy of the biopsy strategy was 98 days compared with 67 days for the no-biopsy strategy, for a net survival benefit of 31 days. Sensitivity analyses revealed that the life expectancy of the biopsy strategy remained greater than the no-biopsy strategy for a wide range of variable specifications. The net survival benefit, however, was sensitive to the diagnostic success rate, the operative mortality, the likelihood of a lymphoma diagnosis, and the life expectancy of patients being diagnosed and treated for lymphoma. These data allow AIDS patients and physicians to learn more about the potential outcomes of the alternative management strategies when an individual fails to respond to empiric antitoxoplasmosis therapy.

NEUROLOGY 1996;46: 1010-1015.

This article has been cited by other articles:

				A. Iranzo, A. Moreno, J. Pujol, J. Martí-Fàbregas, P. Domingo, J. Molet, J. Ris, and J. Cadafalch Proton magnetic resonance spectroscopy pattern of progressive multifocal leukoencephalopathy in AIDS J. Neurol. Neurosurg. Psychiatry, April 1, 1999; 66(4): 520 - 523. [Abstract] [Full Text]

				A. Antinori, G. De Rossi, A. Ammassari, A. Cingolani, R. Murri, D. Di Giuda, A. De Luca, F. Pierconti, T. Tartaglione, M. Scerrati, et al. Value of Combined Approach With Thallium-201 Single-Photon Emission Computed Tomography and Epstein-Barr Virus DNA Polymerase Chain Reaction in CSF for the Diagnosis of AIDS-Related Primary CNS Lymphoma J. Clin. Oncol., February 1, 1999; 17(2): 554 - 554. [Abstract] [Full Text] [PDF]

				I. J. Koralnik, D. Boden, V. X. Mai, C. I. Lord, and N. L. Letvin JC virus DNA load in patients with and without progressive multifocal leukoencephalopathy Neurology, January 1, 1999; 52(2): 253 - 253. [Abstract] [Full Text]