Simulation of medical decisions: Applications of SLN

Simulation has been applied to several important medical deci sion problems using the SLN language. The applications to end- stage renal disease, chronic stable angina, renal artery stenosis, and treatment of hypertension and hypercholesterolemia are reviewed emphasizing the modeling considerations and results. These investigations support the utility of simulation in medical decisions and the applicability of SLN to these problems. The general applicability of simulation to medical decision problems must be evaluated in the context of available knowledge and data. The simulation of medical decisions does not produce dependence among observations so prevalent in discrete-event simulations, but to the extent that arbitrary criteria such as cost- effectiveness are estimated, statistical concerns remain. Simula tion, particularly with SLN, can play an important role in medical protocol design.