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• W2089832007 abstract "Editorials3 May 2011Improving Practice Guidelines With Patient-Specific RecommendationsDouglas K. Owens, MD, MSDouglas K. Owens, MD, MSFrom Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-9-201105030-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical practice guidelines aim to help providers make decisions that optimize patient care (1). Both developers and users of guidelines understand that guidelines could be improved by tailoring the recommendations to the specific circumstances of an individual patient. Tailored guideline recommendations may improve health outcomes when a group of patients can be divided into subgroups in which the tailored recommendations would increase benefits, reduce harms, or save costs relative to more generic recommendations. For example, a guideline for hypertension may recommend antihypertensive treatment in patients whose blood pressure is higher than 140/90 mm Hg. However, patients with diabetes or high ...References1. Institute of Medicine. Clinical Practice Guidelines We Can Trust. Washington, DC: National Academies Pr; 2011. Google Scholar2. Eddy DM, Adler J, Patterson B, Lucas D, Smith KA, Morris M. Individualized guidelines: the potential for increasing quality and reducing costs. Ann Intern Med. 2011;154:627-34. LinkGoogle Scholar3. Owens DK, Nease RF. A normative analytic framework for development of practice guidelines for specific clinical populations. Med Decis Making. 1997;17:409-26. [PMID: 9343799] CrossrefMedlineGoogle Scholar4. Nease RF, Owens DK. A method for estimating the cost-effectiveness of incorporating patient preferences into practice guidelines. Med Decis Making. 1994;14:382-92. [PMID: 7808213] CrossrefMedlineGoogle Scholar5. Sanders GD, Nease RF, Owens DK. Design and pilot evaluation of a system to develop computer-based site-specific practice guidelines from decision models. Med Decis Making. 2000;20:145-59. [PMID: 10772353] CrossrefMedlineGoogle Scholar6. Institute of Medicine. Initial National Priorities for Comparative Effectiveness Research. Washington, DC: National Academies Pr; 2009. Google Scholar7. Hlatky MA, Boothroyd DB, Bravata DM, Boersma E, Booth J, Brooks MM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet. 2009;373:1190-7. [PMID: 19303634] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304.Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government.Acknowledgment: The author thanks Alan M. Garber, MD, PhD, and Sara H. Cody, MD, for their comments and suggestions.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0687.Corresponding Author: Douglas K. Owens, MD, MS, Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 4305-6019; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIndividualized Guidelines: The Potential for Increasing Quality and Reducing Costs David M. Eddy , Joshua Adler , Bradley Patterson , Don Lucas , Kurt A. Smith , and Macdonald Morris Metrics Cited ByExperience in Developing an FHIR Medical Data Management Platform to Provide Clinical Decision SupportDeterminants of facility readiness for integration of family planning with HIV testing and counseling services: evidence from the Tanzania service provision assessment survey, 2014–2015Shades of Grey: Guidelines for Working with the Grey Literature in Systematic Reviews for Management and Organizational StudiesIntegration of Hospital Information and Clinical Decision Support Systems to Enable the Reuse of Electronic Health Record DataAn assessment of population-based screening guidelines versus clinical prediction rules for chlamydia and gonorrhea case findingAutomatic summarization of risk factors preceding disease progression an insight-driven healthcare service case study on using medical records of diabetic patientsA Critical Appraisal of Risk Models for Predicting Sexually Transmitted InfectionsUse of IndiGO individualized clinical guidelines in primary careWho Needs Laboratories and Who Needs Statins?Clinical judgment in psychiatry. Requiem or reveille?Setting clinical priorities: A framework for incorporating individual patient preferencesRisk Prediction in Sexual Health Contexts: ProtocolGuidelines and AlgorithmsGuidelines International Network: Toward International Standards for Clinical Practice GuidelinesAmir Qaseem, MD, PhD, MHA, Frode Forland, MD, DPH, Fergus Macbeth, MD, Günter Ollenschläger, MD, PharmD, PhD, Sue Phillips, PhD, and Philip van der Wees, PhD, PT, for the Board of Trustees of the Guidelines International Network*By Desperate Appliance Relieved? On the Clinical Relevance of Risk Stratification to Therapeutic Decision-MakingTreatment Selection in Depression: The Role of Clinical JudgmentThe Evolving Story of Guidelines and Health Care: Does Being NICE Help?Pamela N. Peterson, MD, MSPH and John S. Rumsfeld, MD, PhDTrustworthy Clinical GuidelinesChristine Laine, MD, MPH, Editor in Chief, Darren B. Taichman, MD, PhD, Executive Deputy Editor, and Cynthia Mulrow, MD, MSc, Senior Deputy Editor 3 May 2011Volume 154, Issue 9Page: 638-639KeywordsBlood pressureCholesterolComparative effectiveness researchHypertensionMyocardial infarctionPatientsSimulation and modelingStable coronary artery diseaseSystolic pressureTreatment guidelines ePublished: 3 May 2011 Issue Published: 3 May 2011 PDF DownloadLoading ..." @default.
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