Modeling the management of a flexor sheath ganglion.

Abstract

In a published cost analysis of the management of flexor sheath ganglia, it was found that two attempts at aspiration, followed by surgical removal for those who failed, was the least costly alternative. We used this report as a template to create a model of the management that could be used in decision analysis. Using the published cohort study as a guide, a decision tree and Markov model of the management of flexor sheath ganglia were created. When compared to the results of a large cohort of patients reported in the literature, we accurately modeled the management of flexor sheath ganglia using both approaches. Creating a model of the management of a disease provides the opportunity to understand and explore questions efficiently and inexpensively. Many disorders of the upper extremity have commonality in their management, making the modeling approach attractive and potentially very valuable. This simple example illustrates two common methods used and is important because it builds confidence in the method by accurately modeling actual clinical experience.