Individualized treatment guidelines can help doctors prevent more heart attacks and strokes than they can by using population-based protocols, according to a new study published in the Annals of Internal Medicine. Researchers found that doctors can develop these guidelines for their patients by using computerized risk calculators integrated with their electronic health records.
The study compared the effectiveness and the costs of the individualized guidelines vs. the national consensus protocols for treating hypertension. By applying their approach to data from a long-term study of 15,800 U.S. residents--of whom 2,700 were eligible for this study--the researchers estimated that individualized treatment could prevent 43 percent more heart attacks and strokes than the national recommendations at the same cost.
The cardiovascular guidelines calculator requires the same data that's used in everyday management of hypertension. If a particular patient's data were entered into a device as simple and as widespread as a personal digital assistant, a physician could calculate the patient's individualized guideline, according to the paper.
"However," the study adds, "implementing individualized guidelines is most efficient in systems that have data warehouses or EHRs to automatically feed the required information to the calculator and display the results. Individualized guidelines are an example of a meaningful use of EHRs, and systems that have EHRs can implement these guidelines more rapidly than those that do not."
David Eddy, MD, the study's lead researcher, estimated that the total savings to the U.S. healthcare system of using this approach to hypertension treatment could exceed $100 billion a year.
Eddy, a highly respected guideline expert, heads Archimedes, the healthcare mathematical modeling company that conducted the study.
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