<i>Annals</i> Clinical Decision Making: Translating Population Evidence to Individual Patients
Authors: Katrina A. Armstrong, Joshua P. Metlay
Journal: Annals of Internal Medicine (2020)

Special Articles5 May 2020Annals Clinical Decision Making: Translating Population Evidence to Individual PatientsKatrina A. Armstrong, MD, MS and Joshua P. Metlay, MD, PhDKatrina A. Armstrong, MD, MSMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.) and Joshua P. Metlay, MD, PhDMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3496 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Most clinical decisions occur at the level of an individual patient. We order a test or start a treatment for a specific person, who has specific characteristics and a specific set of signs and symptoms. In contrast, most studies occur at the level of a population, combining information across lots of patients with different characteristics to estimate the outcome for an average patient. Knowledge of this average effect (does the treatment work? is the test accurate?) is important for determining what options might make sense in any given decision. But more is needed to decide which option is right for ...References1. Armstrong KA, Metlay JP. Annals clinical decision making: communicating risk and engaging patients in shared decision making. Ann Intern Med. 21 April 2020. [Epub ahead of print]. doi:10.7326/M19-3495 LinkGoogle Scholar2. Armstrong KA, Metlay JP. Annals clinical decision making: using a diagnostic test. Ann Intern Med. 2020;172:604-9. doi:10.7326/M19-1940 LinkGoogle Scholar3. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983-8. [PMID: 1866765] CrossrefMedlineGoogle Scholar4. 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[PMID: 24935087] doi:10.1001/jamainternmed.2014.2368 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3496.Corresponding Author: Katrina A. Armstrong, MD, Massachusetts General Hospital, Gray-Bigelow 7, 55 Fruit Street, Boston, MA 02114; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Armstrong: Massachusetts General Hospital, Gray-Bigelow 7, 55 Fruit Street, Boston, MA 02114.Dr. Metlay: Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114.Author Contributions: Conception and design: K.A. Armstrong, J.P. Metlay.Drafting of the article: K.A. Armstrong, J.P. Metlay.Critical revision of the article for important intellectual content: K.A. Armstrong, J.P. Metlay.Final approval of the article: K.A. Armstrong, J.P. Metlay.Administrative, technical, or logistic support: K.A. Armstrong.This article was published at Annals.org on 21 April 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Decision Making: Nurturing Our Core Skills Darren B. Taichman , Sankey V. Williams , and Christine Laine Annals Clinical Decision Making: Communicating Risk and Engaging Patients in Shared Decision Making Katrina A. Armstrong and Joshua P. Metlay Metrics Cited byThe future of research in hematology: Integration of conventional studies with real-world data and artificial intelligenceCan Machine Learning from Real-World Data Support Drug Treatment Decisions? 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Armstrong, MD, MSClinical Decision Making: Nurturing Our Core SkillsDarren B. Taichman, MD, PhD, Executive Editor, Sankey V. Williams, MD, Deputy Editor, and Christine Laine, MD, MPH, Editor in Chief Using the Causal Inference Framework to Support Individualized Drug Treatment Decisions Based on Observational Healthcare Data 5 May 2020Volume 172, Issue 9Page: 610-616KeywordsAtrial fibrillationDecision makingGenomicsHemorrhageHypertensionInternational normalized ratioMedical risk factorsPrecision medicineRelative riskStroke ePublished: 21 April 2020 Issue Published: 5 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...