TY - JOUR
T1 - Patient profiled data for treatment decision-making
T2 - valuable as an add-on to hepatitis C clinical guidelines?
AU - Brakenhoff, Sylvia M.
AU - Theijse, Thymen
AU - van Wijngaarden, Peter
AU - Trautwein, Christian
AU - Brozat, Jonathan F.
AU - Tacke, Frank
AU - Honkoop, Pieter
AU - Vanwolleghem, Thomas
AU - Posthouwer, Dirk
AU - Zeuzem, Stefan
AU - Mihm, Ulrike
AU - Wedemeyer, Heiner
AU - Berg, Thomas
AU - Schalm, Solko W.
AU - de Knegt, Robert J.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/8/13
Y1 - 2024/8/13
N2 - Background and Aims: Systematic reviews and medical guidelines are widely used in clinical practice. However, these are often not up-to-date and focussed on the average patient. We therefore aimed to evaluate a guideline add-on, TherapySelector (TS), which is based on monthly updated data of all available high-quality studies, classified in specific patient profiles. Methods: We evaluated the TS for the treatment of hepatitis C (HCV) in an international cohort of patients treated with direct-acting antivirals between 2015 and 2020. The primary outcome was the number of patients receiving one of the two preferred treatment options of the HCV TS, based on the highest level of evidence, cure rate, absence of ribavirin-associated adverse effects, and treatment duration. Results: We enrolled 567 patients. The number of patients treated with one of the two preferred treatment options according to the HCV TS ranged between 27% (2015) and 60% (2020; p < 0.001). Most of the patients received a regimen with a longer treatment-duration (up to 34%) and/or addition of ribavirin (up to 14%). The effect on the expected cure-rate was minimal (1–6% higher) when the first preferred TherapySelector option was given compared to the actual treatment.Conclusions: Medical decision-making can be optimised by a guideline add-on; in HCV its use appears to minimise adverse effects and cost. The use of such an add-on might have a greater impact in diseases with suboptimal cure-rates, high costs or adverse effects, for which treatment options rely on specific patient characteristics.
AB - Background and Aims: Systematic reviews and medical guidelines are widely used in clinical practice. However, these are often not up-to-date and focussed on the average patient. We therefore aimed to evaluate a guideline add-on, TherapySelector (TS), which is based on monthly updated data of all available high-quality studies, classified in specific patient profiles. Methods: We evaluated the TS for the treatment of hepatitis C (HCV) in an international cohort of patients treated with direct-acting antivirals between 2015 and 2020. The primary outcome was the number of patients receiving one of the two preferred treatment options of the HCV TS, based on the highest level of evidence, cure rate, absence of ribavirin-associated adverse effects, and treatment duration. Results: We enrolled 567 patients. The number of patients treated with one of the two preferred treatment options according to the HCV TS ranged between 27% (2015) and 60% (2020; p < 0.001). Most of the patients received a regimen with a longer treatment-duration (up to 34%) and/or addition of ribavirin (up to 14%). The effect on the expected cure-rate was minimal (1–6% higher) when the first preferred TherapySelector option was given compared to the actual treatment.Conclusions: Medical decision-making can be optimised by a guideline add-on; in HCV its use appears to minimise adverse effects and cost. The use of such an add-on might have a greater impact in diseases with suboptimal cure-rates, high costs or adverse effects, for which treatment options rely on specific patient characteristics.
UR - http://www.scopus.com/inward/record.url?scp=85201242829&partnerID=8YFLogxK
U2 - 10.1186/s12911-024-02608-x
DO - 10.1186/s12911-024-02608-x
M3 - Article
C2 - 39138441
AN - SCOPUS:85201242829
SN - 1472-6947
VL - 24
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 227
ER -
