The art of management decision making: from intuition to evidence-based medicine

This article summarizes available evidence on various management options for vestibular schwannoma as they relate to the decision-making strategies used in selection. After a brief consideration of individual options, the literature directly comparing two or more management options is examined, noting the level of evidence supporting their claims. A discussion of the strategies developed to guide decision making follows. The article closes with a summary of the evidence-based findings and suggestions for further research. The focus is on management of sporadic, unilateral vestibular schwannomas, because patients with neurofibromatosis type 2 pose different management problems best discussed separately.