Management of Suspected Temporal Arteritis: A Decision Analysis

Management strategies for suspected temporal arteritis range from bilateral temporal artery biopsy to empiric corticosteroid therapy. A decision analysis of the clinical situation was constructed, and a sensitivity analysis for varying prevalences of temporal arteritis was used to calculate costs for different management strategies. Conclusions suggested by the analysis include the following: (1) due to the high cost of blindness, suspicion of disease must be low (< 1.4070) not to biopsy; (2) at high suspicion of disease (> 30Vo), empiric steroids are the cheapest management; (3) when diagnostic procedures are indicated, bilateral biopsy is the cheapest initial diagnostic procedure; and (4) if unilateral biopsy is negative, a second biopsy is always cost effective. (Med Decis Making 3:63-68, 1983).