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PRACTICE PERSPECTIVES Optimizing Small, Low-Risk, Unruptured Intracranial Aneurysm Treatment Using Game Theory A.T. Boltyenkov, J.J. Wang, A. Malhotra, J.M. Katz, A.R. Dehdashti, T.G. White, G. Martinez, A. Pandya, and P.C. Sanelli ABSTRACT SUMMARY: The incidental diagnosis of unruptured intracranial aneurysms has been increasing in the past several decades. A significant proportion represent small, low-risk, unruptured intracranial aneurysms for which there is equipoise on whether to offer treatment or conservative management. Given this uncertainty, patients may not always be comfortable with their physicians’ recommendations. Herein, we use game theory to study the interactions between physicians and patients to determine how conflict and cooperation affect the management of small, low-risk, unruptured intracranial aneurysms. We constructed a game theory model of the interaction between physicians and patients with respect to decision-making for a small, low-risk, unruptured intracranial aneurysm in an asymptom- atic patient when there is perceived equipoise between whether to treat or manage conservatively. Assuming that both the physician and patient are rational and eliciting individual patient preferences is not practical, the physician should play the game based on an ex ante probability of meeting a patient with a certain type of preference. This recommendation means that the expectations of the
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Feb 1, 2022
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