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Prioritizing USPSTF recommendations based on patient characteristics may improve life-expectancy

A shows that () recommendations can be prioritized on the patient level to improve life-expectancy. Currently, the makes recommendations for 60 distinct clinical services. However, only about half of these recommended services are provided to patients and utilization for some services remains very low.

How to prioritize what to do in the limited time of a clinical encounter is a pervasive problem in primary care. Researchers used a mathematical model to prioritize preventive care services by examining each USPSTF recommendation in the context of a person’s risk-benefit profile and how life-expectancy could be influenced by the intervention.

The model showed that the rank order of benefits varied considerably based on demographic characteristics, medical conditions, and lifestyle choices. Based on the model, a 62-year-old obese man who smoked and had high cholesterol, hypertension, and a family history of colorectal cancer would benefit most from USPSTF recommendations on tobacco cessation, weight loss, and blood pressure control. Changing or adding other characteristics influences which recommendations become a priority and their rank order.

The authors of an accompanying editorial write that the model helps physicians to understand the relative importance of different interventions for a specific patient. They suggest that extending the analysis to measure for a broader set of outcomes, such as quality-adjusted life years and cost effectiveness, may be valuable. In addition, issues such as public health should also be considered.

Source

News from the Annals of Internal Medicine: Aug. 6, 2013

American College of Physicians