Distribution of lifespan gain from primary prevention intervention.
Open Heart
; 3(1): e000343, 2016.
Article
de En
| MEDLINE
| ID: mdl-27042321
ABSTRACT
OBJECTIVE:
When advising patients about possible initiation of primary prevention treatment, clinicians currently do not have information on expected impact on lifespan, nor how much this increment differs between individuals.METHODS:
First, UK cardiovascular and non-cardiovascular mortality data were used to calculate the mean lifespan gain from an intervention (such as a statin) that reduces cardiovascular mortality by 30%. Second, a new method was developed to calculate the probability distribution of lifespan gain. Third, we performed a survey in three UK cities on 11â days between May-June 2014 involving 396 participants (mean age 40â years, 55% male) to assess how individuals evaluate potential benefit from primary prevention therapies.RESULTS:
Among numerous identical patients, the lifespan gain, from an intervention that reduces cardiovascular mortality by 30%, is concentrated within an unpredictable minority. For example, men aged 50â years with national average cardiovascular risk have mean lifespan gain of 7â months. However, 93% of these identical individuals gain no lifespan, while the remaining 7% gain a mean of 99â months. Many survey respondents preferred a chance of large lifespan gain to the equivalent life expectancy gain given as certainty. Indeed, 33% preferred a 2% probability of 10â years to fivefold more gain, expressed as certainty of 1â year.CONCLUSIONS:
People who gain lifespan from preventative therapy gain far more than the average for their risk stratum, even if perfectly defined. This may be important in patient decision-making. Looking beyond mortality reduction alone from preventative therapy, the benefits are likely to be even larger.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Type d'étude:
Prognostic_studies
Langue:
En
Journal:
Open Heart
Année:
2016
Type de document:
Article
Pays d'affiliation:
Royaume-Uni