Table 1. Probabilities for decision tree

Name of branch

Definition of branch (a)

 

Watchful Following Option

Probability: variable and value

Source

Dysp regresses from CIN 1

Dysplasia regresses from CIN 1/watchful follow

preggfol = .57

Ostor, 1993

Dysp persists as CIN 1

Dysplasia persists as CIN 1/watchful follow

ppergfol = proporpersist

* (1 - preggfol)

= .74*(1- 57) = .318

Ostor, 1993

Dysp progresses to CIN 2

Dysplasia progresses to CIN 2/watchful follow

pCIN2

= propCIN2* (1-preggfol-ppergfol)

= .5 * (1-.57-.318)

= .056

Authors' judgment

Dysp progresses to CIN 3

Dysplasia progresses to CIN 2/watchful follow

# = .056

Nasiell, 1986, Ostor, 1993,

Authors' judgment

Dis req invas proc (1)

Persisting dysplasia requires invasive procedure/persists (Invasive Procedure Situation 1)

pCIN1reqinvproc = .35*pdisreqinvas = .35 * .2 = .07

Authors' judgment

Does not req invas proc

Persisting dysplasia does not require invasive procedure/persists

# = .93

#

1st Cryo g dys pers

Doctor chooses cryotherapy/dysplasia persists and does not require invasive procedure

pcryogpersist = pcryovsinvas = .75

Authors' judgment

Dr. choose invas proc (4)

Doctor chooses invasive procedure/dysplasia persists and does not require invasive procedure (Invasive Procedure Situation 4)

# = .25

#

Cure with 1 cryo g pers

Cryotherapy cures dysplasia/dysplasia persists and doctor chooses cryotherapy

pcurg1cryopers = .98*pcurgcryo

= .98 * .95 = .931

Benedet, 1987, Ostergard, 1980, Creaseman, 1981, Authors' judgment

Not cured

Cryotherapy does not cure persisting dysplasia

# = .069

#

Possible to view

It is possible to view cervix with colposcope /cryotherapy did not cure persisting dysplasia

pviewg1cryfail = pviewgimcryfail = .70

Jobson, 1984, Einerth, 1988, Ferenczy, 1985

Not viewable, diagnosis requires invas proc (11)

It is not possible to view cervix with colposcope /cryotherapy did not cure persisting dysplasia (Invasive Procedure Situation 11)

# = .30

#

Dis req invas proc (2)

Disease requires invasive procedure /cryotherapy did not cure persisting dysplasia, and cervix can be viewed adequately with colposcopy (Invasive Procedure Situation 2)

pdreqinvg1crgper = 1 - .81 * (1 - pdisreqinvas)

= 1 - .81 * (1 - .2)

= .352

Authors' judgment

Inv proc not required

Disease does not require invasive procedure /cryotherapy did not cure persisting dysplasia, and cervix can be viewed

# = .648

#

Doc choose cryo

Doctor chooses to repeat cryotherapy /first cryotherapy failed on persisting dysplasia, and invasive procedure is not required

p2cryg1crfaigper = .20 * pcryovsinvas = .20 * .75 = .15

Authors' judgment

Dr. choose inv proc (3)

Doctor chooses invasive procedure /first cryotherapy failed on persisting dysplasia, and invasive procedure is not required (Invasive Procedure Situation 3)

# = .85

#

Cure g 2 cryos

The second cryotherapy cures the dysplasia that had been treated with cryotherapy after persisting

pcurg2cryo

= .95 * pcurgcryo

= .95 * .95 = .903

Benedet, 1987, Ostergard, 1980, Creaseman, 1981, Authors' judgment

Cryo ineffective (9)

The second cryotherapy fails to cure the dysplasia that had been treated with cryotherapy after persisting (Invasive Procedure Situation 9)

# = .097

#

Dis req invas proc (51)

Progressing dysplasia requires invasive procedure/ progresses to CIN 2 (Invasive Procedure Situation 51)

pCIN2reqinvproc = pdisreqinvas

= .20

Authors' judgment

Does not req inv proc

Progressing dysplasia does not require invasive procedure /progresses to CIN 2

# = .80

#

1st Cryo g dys prog

Doctor chooses cryotherapy /dysplasia progresses to CIN 2 and does not require invasive procedure

pcryogCIN2 = .8 * pcryovsinvas

= .8 * .75 = .60

Authors' judgment

Dr. chooses invas proc (121)

Doctor chooses invasive procedure /dysplasia progresses to CIN 2 and does not require invasive procedure (Invasive Procedure Situation 121)

# = .40

#

Cure with 1 cryo g prog

Cryotherapy cures dysplasia/dysplasia progresses to CIN 2 and doctor chooses cryotherapy

pcurg1cryoprog

= .95 * pcurgcryo

= .95 * .95 = .903

Benedet, 1987, Ostergard, 1980, Creaseman, 1981, Authors' judgment

Not cured

Cryotherapy does not cure dysplasia/dysplasia progresses to CIN 2 and doctor chooses cryotherapy

# = .097

#

Possible to view

It is possible to view cervix with colposcope /cryotherapy did not cure dysplasia that progressed to CIN 2

pviewg1cryfail

= pviewgimcryfail

= .70

Jobson, 1984, Einerth, 1988, Ferenczy, 1985

Not viewable, diagnosis requires invas proc (101)

It is not possible to view cervix with colposcope /cryotherapy did not cure dysplasia that progressed to CIN 2 (Invasive Procedure Situation 101)

# = .30

#

Dis req invas proc (61)

Disease requires invasive procedure /cryotherapy did not cure dysplasia that progressed to CIN 2, and cervix can be viewed adequately with colposcopy (Invasive Procedure Situation 61)

pdreqinvg1crgpro

= 1-.525*(1-pdisreqinvas)

= 1-.525*(1-.20)

= .58

Authors' judgment

Inv proc not required

Disease does not require invasive procedure /cryotherapy did not cure dysplasia that progressed to CIN 2, and cervix can be viewed

# = .42

#

Doc choose cryo

Doctor chooses to repeat cryotherapy /first cryotherapy failed on dysplasia that progressed to CIN 2, and invasive procedure is not required

p2cryg1crfaigpro = .1333*pcryovsinvas

= .1333 * .75

= .10

Authors' judgment

Dr. chooses invas proc (71)

Doctor chooses invasive procedure /first cryotherapy failed on dysplasia that progressed to CIN 2, and invasive procedure is not required (Invasive Procedure Situation 71)

# = .90

#

Cure g 2 cryos

The second cryotherapy cures the dysplasia that had been treated with cryotherapy after progressing to CIN 2

pcurg2cryogprog

= .85 * pcurgcryo

= .85 * .95 = .808

Benedet, 1987, Ostergard, 1980, Creaseman, 1981, Authors' judgment

Cryo ineffective (81)

The second cryotherapy fails to cure the dysplasia that had been treated with cryotherapy after progressing to CIN 2 (Invasive Procedure Situation 81)

# = .192

#

Dis req invas proc (52)

Progressing dysplasia requires invasive procedure/ progresses to CIN 3 (Invasive Procedure Situation 52)

pcin3reqinvproc = 1.0

Authors' judgment

 

 

Immediate Cryotherapy Option

 

 

Cure with immed cryotherapy

Immediate cryotherapy cures dysplasia

pcurgimcryo

= pcurgcryo

= .95

Benedet, 1987, Ostergard, 1980, Creaseman, 1981,

Not cured

Immediate cryotherapy does not cure dysplasia

# = .05

#

Possible to view

It is possible to view cervix with colposcope /immediate cryotherapy did not cure dysplasia

pviewgimcryfail

= .70

Jobson, 1984, Einerth, 1988, Ferenczy, 1985

Not viewable, diagnosis requires invas proc (13)

It is not possible to view cervix with colposcope /immediate cryotherapy did not cure dysplasia (Invasive Procedure Situation 13)

# = .30

#

Dis req invas proc (14)

Disease requires invasive procedure /immediate cryotherapy did not cure dysplasia, and cervix can be viewed adequately with colposcopy (Invasive Procedure Situation 14)

pdreqinvgimcrfai = 1 - .875 * (1 - pdisreqinvas)

= 1-.875*(1-.2)

= .30

Authors' judgment

Inv proc not required

Disease does not require invasive procedure /immediate cryotherapy did not cure dysplasia, and cervix can be viewed

# = .70

#

Doc choose cryo

Doctor chooses to repeat cryotherapy /immediate cryotherapy did not cure dysplasia, and cervix can be viewed

p2crygimcryfail = .3333*pcryovsinvas

.3333 * .75 = .25

Authors' judgment

Dr. chooses invas proc (15)

Doctor chooses invasive procedure /immediate cryotherapy failed, and invasive procedure is not required (Invasive Procedure Situation 15)

# = .75

#

Cure g 2 cryos

The second cryotherapy cures the dysplasia that had been immediately treated with cryotherapy

pcurg2cryo

= .95 * pcurgcryo

= .95 * .95 = .903

Benedet, 1987, Ostergard, 1980, Creaseman, 1981, Authors' judgment

Cryo ineffective, so do invasive proc (16)

The second cryotherapy fails to cure the dysplasia that had been treated immediately with cryotherapy (Invasive Procedure Situation 16)

# = .097

#

a The symbol "/" in the definition of the branch indicates the previous branch, and can be read as "given".

# indicates this probability is the complement of probabilities immediately higher in the table.

 

 

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