A review of the past five years finds four efforts to model decisions regarding localized prostate cancer. Sequentially, each model is described and evaluated in terms of its strengths and weaknesses. We found that all models of localized prostate cancer decision making suffer from a number of problems, most notably due to a previously noted lack of unbiased data concerning the natural history of the disease but also due to flaws in the design of the models and the use of available data. Despite the problems with the conclusions of computer models developed thus far, major strides have been made. Emphasis must be placed on obtaining better data to use in these models and on improving the models' logical structure so as to make better use of the available data. Computer models augment but do not replace randomized clinical trials.
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