IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v31y2011i4p582-595.html
   My bibliography  Save this article

Can Life Expectancy and QALYs Be Improved by a Framework for Deciding Whether to Apply Clinical Guidelines to Patients With Severe Comorbid Disease?

Author

Listed:
  • R. Scott Braithwaite

Abstract

Background: Guidelines with short-term harms and long-term benefits are often applied to chronically ill patients who may not benefit. The payoff time framework has been proposed (i.e., do not apply a guideline if a patient’s life expectancy (LE) is shorter than when a guideline’s cumulative incremental benefits first exceed its cumulative incremental harms), but its health impact is unclear. Objective: To investigate whether the payoff time framework improves LE and/or quality-adjusted life-years (QALY) for chronically ill patients. Methods: I evaluate impact of the payoff time framework on LE and QALYs, assuming (1) high and constant background mortality rate from chronic illness (≥ 10% per year), (2) immediate guideline-related harm with probability 0.15 per year (corresponding to LE 0.11 per year (corresponding to LE

Suggested Citation

  • R. Scott Braithwaite, 2011. "Can Life Expectancy and QALYs Be Improved by a Framework for Deciding Whether to Apply Clinical Guidelines to Patients With Severe Comorbid Disease?," Medical Decision Making, , vol. 31(4), pages 582-595, July.
    • Handle: RePEc:sae:medema:v:31:y:2011:i:4:p:582-595
    DOI: 10.1177/0272989X10386117
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X10386117
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X10386117?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:31:y:2011:i:4:p:582-595. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.