Researchers offer new model, helping clinicians prioritize recommended preventive

August 5, 2013, New York University School of Medicine

With physicians facing increasing demands on their time, it can be extremely difficult to prioritize which preventive care methods should be used for their patients. Now, two researchers at NYU Langone Medical Center have developed a mathematical model that will save time, lead to enhanced care, and potentially save lives.

The two researchers, Glen Taksler, PhD and Scott Braithwaite, MD, MSc, have co-authored the lead article in the August 6th issue of Annals of Internal Medicine, entitled "Personalized Estimates of Benefit from Preventive Care Guidelines: A Proof of Concept."

Glen Taksler, PhD, a post-doctoral fellow in the Departments of Population Health and Medicine, and Scott Braithwaite, MD, MSc, professor, Departments of Population Health and Medicine and the chief of the Division of Comparative Effectiveness and Decision Science, saw the need for a new model when contemplating the list of United States Preventive Services Task Force (USPSTF) recommendations for 60 distinct clinical services.

While the delivery of preventive has improved in the last decade, only about half of recommended services are provided. Utilization remains alarmingly low for some services (e.g., 48% are not screened for colorectal cancer), particularly among minorities.

"A more systematic approach to prioritizing guidelines could potentially save lives, and we suggest doing so through the use of personalized models of health care," said Dr. Taksler. According to the researchers, personalized medical models ensure that medical decisions, products or practices are tailored to the individual patient. Though medicine has always been inherently "personal" to each patient (e.g. their symptoms, medical and family history and laboratory data), personalized models usually include the use of technology or discovery enabling a level of personalization not previously possible.

"Personalized models of health care may help physicians learn which preventive care guidelines have the greatest benefit for each patient," said Dr. Taksler. He also explained that personalization should become more popular as electronic medical records streamline information to physicians and other health care providers.

To facilitate personalized decision-making at the point of care, the two researchers undertook a demonstration project to mathematically model how much longer an individual could expect to live by following preventive care guidelines. Dr. Braithwaite said the approach "focuses on the whole patient and other patients just like him or her." The researchers highlighted a 62-year-old obese man who smoked, had high blood pressure, high cholesterol, and a family history of colorectal cancer. They found that it was most important for the patient to quit smoking, lose weight, and lower his blood pressure. Screenings for colorectal cancer and abdominal aortic aneurysm, while still recommended, were a lower priority. By contrast, if the same man also had type II diabetes, then controlling his blood sugar would become the top priority.

"While other investigators have attempted to personalize health care, we were the first to combine all major recommendations into a single, easy-to-use framework," said Dr. Braithwaite.

The researchers currently are incorporating this decision support model in a busy primary care clinic as part of an ongoing pilot study. Using electronic health records to help pre-identify patients with the largest potential gains from personalization, a Nurse Practitioner discusses these personalized recommendations with patients, pursuing a shared decision about which goals a patient would like to achieve. A health coach then discusses practical means for achieving these objectives. The researchers look forward to learning the results after the study concludes in 2014.

Drs. Taksler and Braithwaite agree that "the era of personalized medicine is here to stay."

Explore further: Researchers develop system that uses a big data approach to personalized healthcare

Related Stories

Researchers develop system that uses a big data approach to personalized healthcare

July 25, 2013
University of Notre Dame researchers have developed a computer-aided method that uses electronic medical records to offer the promise of rapid advances toward personalized health care, disease management and wellness.

Interactive personal health records increase clinical preventive services

July 10, 2012
Patients who use an interactive personal health record (IPHR) are almost twice as likely to be up to date with clinical preventive services as those who do not, according to a new study led by Alex Krist, M.D., M.P.H., research ...

Chronic illness positively linked to receipt of preventive care

July 10, 2013
(HealthDay)—Patients with one or more chronic illnesses are not less likely to receive recommended preventive health services, according to a study published in the July/August issue of the Annals of Family Medicine.

Delivering the best care to the right patient at the right time

June 25, 2013
There are two popular models when it comes to delivering the best healthcare – using evidence-based guidelines or applying personalized medicine. Each method has its own merits and drawbacks, but according to one Northwestern ...

Patient centered medical home helps assess social health determinants and promote health

April 25, 2013
Physicians from the Departments of Pediatrics and Family Medicine at Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) are proposing that current pediatric guidelines and practices could be implemented ...

Can team-based care improve primary care delivery and patient outcomes?

April 22, 2013
In a team-based care approach, a diverse group of clinicians shares responsibility for a panel of patients and consults with each other regularly. This model of delivering primary care can improve patient care, practice workflows, ...

Recommended for you

Air pollution may shorten telomeres in newborns

January 24, 2018
A study conducted before and after the 2004 closure of a coal-burning power plant in Tongliang, China, found children born before the closure had shorter telomeres than those conceived and born after the plant stopped polluting ...

Number of older people with four or more diseases will double by 2035, say researchers

January 23, 2018
A study published today in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third ...

Placental accumulation of flame retardant chemical alters serotonin production in rats

January 22, 2018
A North Carolina State University-led research team has shown a connection between exposure to a widely used flame retardant chemical mixture and disruption of normal placental function in rats, leading to altered production ...

Marijuana use does not lower chances of getting pregnant

January 22, 2018
Marijuana use—by either men or women—does not appear to lower a couple's chances of getting pregnant, according to a new study led by Boston University School of Public Health (BUSPH) researchers.

Women run faster after taking newly developed supplement, study finds

January 19, 2018
A new study found that women who took a specially prepared blend of minerals and nutrients for a month saw their 3-mile run times drop by almost a minute.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.