Thesis Type: Postgraduate
Institution Of The Thesis: Orta Doğu Teknik Üniversitesi, Faculty of Engineering, Department of Industrial Engineering, Turkey
Approval Date: 2006
Student: LEMAN ESRA DOLGUN
Supervisor: GÜLSER KÖKSALAbstract:
The purpose of this study was to develop a decision model for early-stage breast cancer patients. This model provides an opportunity for comparing two main treatment options, mastectomy and lumpectomy, with respect to quality of life by making use of Decision Theoretic Techniques. A Markov chain was constructed to project the clinical history of breast carcinoma following surgery. Then, health states used in the model were characterized by transition probabilities and utilities for quality of life. A Multi Attribute Utility Model was developed for outcome evaluation. This study was performed on the sample population of female university students, and utilities were elicited from these healthy volunteers. The results yielded by Multi Attribute Utility Model were validated by using Von Neumann-Morgenstern Standard Gamble technique. Finally, Monte Carlo Simulation was utilized in Treeage-Pro 2006 Suit software program in order to solve model and calculate expected utility value generated by each treatment option. The results showed that lumpectomy is more favorable for people who participated in this study. Sensitivity analysis on transition probabilities to local recurrence and salvaged states was performed and two threshold values were observed. Additionally, sensitivity analysis on utilities showed that the model was more sensitive to no evidence of disease state; however, was not sensitive to utilities of local recurrence and salvaged states.