Prioritizing Guideline-Recommended Interventions
Authors: Douglas K. Owens, Jeremy D. Goldhaber-Fiebert
Journal: Annals of Internal Medicine (2013)

EditorialsAugust 6, 2013Prioritizing Guideline-Recommended InterventionsDouglas K. Owens, MD, MS and Jeremy D. Goldhaber-Fiebert, PhDDouglas K. Owens, MD, MSFrom Veterans Affairs Palo Alto Health Care System and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California; and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California.Search for more papers by this author and Jeremy D. Goldhaber-Fiebert, PhDFrom Veterans Affairs Palo Alto Health Care System and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California; and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-3-201308060-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Imagine that a new patient named “Bill,” who is aged 62 years, comes to your clinic for a visit. You want to deliver guideline-recommended preventive care and decide to use the U.S. Preventive Services Task Force (USPSTF) guidelines. More than 10 separate guidelines are relevant to Bill. Following the guidelines, you screen for hypertension, hyperlipidemia, colon cancer, depression, alcohol misuse, depression, diabetes, HIV, obesity, and tobacco use. You learn that Bill is obese; smokes; and has high cholesterol, hypertension, and diabetes. Given his risk factors, USPSTF guidelines indicate that Bill would be eligible for aspirin use to prevent cardiovascular disease; ...References1. Taksler GB, Keshner M, Fagerlin A, Hajizadeh N, and Braithwaite RS. Personalized estimates of benefit from preventive care guidelines. A proof of concept. Ann Intern Med. 2013;159:161-8. LinkGoogle Scholar2. Sanders GD, Bayoumi AM, Sundaram V, Bilir SP, Neukermans CP, Rydzak CE, et al. Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med. 2005;352:570-85. [PMID: 15703422] CrossrefMedlineGoogle Scholar3. Mandelblatt JS, Cronin KA, Bailey S, Berry DA, de Koning HJ, Draisma G, et al. Breast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network. Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 2009;151:738-47 LinkGoogle Scholar4. Zauber AG, Lansdorp-Vogelaar I, Knudsen AB, Wilschut J, van Ballegooijen M, and Kuntz KM. Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:659-69 LinkGoogle Scholar5. Owens DK and Shekelle PG. Quality of life, utilities, quality-adjusted life years, and health care decision making: comment on “Estimating quality of life in acute venous thrombosis.”. JAMA Intern Med. 2013;173:1073-4. CrossrefMedlineGoogle Scholar6. Owens DK, Qaseem A, Chou R, and Shekelle P; Clinical Guidelines Committee of the American College of Physicians. High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions. Ann Intern Med. 2011;154:174-80 LinkGoogle Scholar7. Sox HC, Higgins MC, and Owens DK. Medical Decision Making. 2nd ed. Chichester, UK J Wiley 2013 330-2. Google Scholar8. Anaya HD, Hoang T, Golden JF, Goetz MB, Gifford A, Bowman C, et al. Improving HIV screening and receipt of results by nurse-initiated streamlined counseling and rapid testing. J Gen Intern Med. 2008;23:800-7. [PMID: 18421508] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Palo Alto Health Care System and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California; and Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, Stanford, California.Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, U.S. government, or USPSTF.Financial Support: Dr. Owens is supported by the Department of Veterans Affairs. Dr. Goldhaber-Fiebert is supported by a National Institutes of Health career development award (K01 AG037593).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1497.Corresponding Author: Douglas K. Owens, MD, MS, Center for Primary Care and Outcomes Research and Center for Health Policy, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019; e-mail, [email protected].Current Author Addresses: Drs. Owens and Goldhaber-Fiebert: 117 Encina Commons, Stanford, CA 94305. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPersonalized Estimates of Benefit From Preventive Care Guidelines Glen B. Taksler , Melanie Keshner , Angela Fagerlin , Negin Hajizadeh , and R. Scott Braithwaite Metrics Cited ByOpportunities for Quality Measurement to Improve the Value of Care for Patients With Multiple Chronic ConditionsArjun K. Venkatesh, MD, MBA, MHS, Kate Goodrich, MD, MHS, and Patrick H. Conway, MD, MScPersonalized Estimates of Benefit From Preventive Care GuidelinesJan Matthys, MDPersonalized Estimates of Benefit From Preventive Care GuidelinesGlen B. Taksler, PhD and R. Scott Braithwaite, MD, MSc August 6, 2013Volume 159, Issue 3Page: 223-224KeywordsAlcoholsBlood pressureCardiovascular diseasesCholesterolColorectal cancerDietExerciseHIVHypercholesterolemiaHyperlipidemiaHypertensionLife expectancyMammographyMathematical modelsMedical risk factorsObesityOverweightPrevention, policy, and public healthPreventive medicineWeight loss ePublished: 6 August 2013 Issue Published: August 6, 2013 PDF DownloadLoading ...