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Improving Practice Guidelines With Patient-Specific Recommendations

Douglas K. Owens, MD, MS
[+] Article, Author, and Disclosure Information

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.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0687.

Requests for Single Reprints: Douglas K. Owens, MD, MS, Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 4305-6019; e-mail, owens@stanford.edu.

Ann Intern Med. 2011;154(9):638-639. doi:10.7326/0003-4819-154-9-201105030-00010
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In this issue, Eddy and colleagues' mathematical model shows that initiating treatment for hypertension on the basis of individual patient characteristics results in better outcomes than does use of the simpler JNC 7 guidelines. The editorialist notes the tradeoffs that guideline developers face in terms of usability versus tailoring: The relative simplicity of generic recommendations makes them easier for clinicians to remember and implement, but the simplicity could come at a loss of potential benefit, increased cost, or both. For individualized guidelines to improve outcomes, they must be easy for clinicians to apply.

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