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In the year 2000 lung cancer was operated in 349 patients in Norway, in 2010 the number was 461. In the first period fatal surgical hemorrhage occurred in eight patients, in four of them peroperatively. Postoperative hemorrhage occurred in four patients in the year 2000 and in two in 2010. Ten patients died intra- or postoperatively in the two periods which is a mortality rate within 30 days after surgery of 4.3% in the first and 1.1% in the second period. Pneumonectomy was performed in 34 patients in 2000 and eight in 2010, respectively. Altogether 19 patients died within six months after surgery without having experienced surgical complications. Pneumonectomy should not be performed in elderly and debilitated persons.
In recent years,
increased attention has been given to guidelines for cost-effectiveness
analysis of medical interventions, and some of these guidelines (such as NICE
) have become rather influential. In the paper, we present a model of
retrieving and processing information to be used for the study of guidelines
and their use. Our main result, which relies on a version of the theorem of
Blackwell , shows that in cases where there are sufficiently many decisions
to be made on the basis of the information obtained, there can be no other
objective ranking of methods than the trivial one ranking more information is
higher than less information. In our context, this means that guidelines may
have administrative advantages but cannot be considered as a scientifically
based approach to better decision making.