Statins by Numbers
By JASON KARLAWISH, NYT
PHILADELPHIA — MEDICINE is having its moneyball moment.
In his book “Moneyball,” Michael Lewis chronicled how the Oakland A’s, in order to identify the best predictors of a winning baseball team, used a highly formulaic, statistics-driven approach in place of the traditional assessments of coaches and managers. This month, in a similar spirit, the American Heart Association and the American College of Cardiology issued new, numerically driven guidelines for the treatment of cardiovascular disease.
These guidelines recommend that doctors no longer use a patient’s LDL cholesterol level to decide whether to prescribe a cholesterol-lowering statin, and instead rely on the results of a web-based “risk calculator” — the Omnibus Risk Estimator — that determines a person’s chances of suffering atherosclerotic cardiovascular disease in 10 years.
Into the Omnibus Risk Estimator you enter nine variables, including age, sex, total cholesterol and systolic blood pressure, and the estimator returns your 10-year and lifetime risks of stroke, heart attack or death from cardiovascular disease. With these data, you and your doctor decide whether to invest in a lifetime of daily therapy with a statin pill.
This is a revolutionary shift. Once upon a time, medicine was a discipline based on the nuanced diagnosis and treatment of sick patients. Now, Big Data, networked computers and a culture obsessed with knowing its numbers have moved medicine from the bedside to the desktop (or laptop). The art of medicine is becoming the science of an insurance actuary.
(More here.)
PHILADELPHIA — MEDICINE is having its moneyball moment.
In his book “Moneyball,” Michael Lewis chronicled how the Oakland A’s, in order to identify the best predictors of a winning baseball team, used a highly formulaic, statistics-driven approach in place of the traditional assessments of coaches and managers. This month, in a similar spirit, the American Heart Association and the American College of Cardiology issued new, numerically driven guidelines for the treatment of cardiovascular disease.
These guidelines recommend that doctors no longer use a patient’s LDL cholesterol level to decide whether to prescribe a cholesterol-lowering statin, and instead rely on the results of a web-based “risk calculator” — the Omnibus Risk Estimator — that determines a person’s chances of suffering atherosclerotic cardiovascular disease in 10 years.
Into the Omnibus Risk Estimator you enter nine variables, including age, sex, total cholesterol and systolic blood pressure, and the estimator returns your 10-year and lifetime risks of stroke, heart attack or death from cardiovascular disease. With these data, you and your doctor decide whether to invest in a lifetime of daily therapy with a statin pill.
This is a revolutionary shift. Once upon a time, medicine was a discipline based on the nuanced diagnosis and treatment of sick patients. Now, Big Data, networked computers and a culture obsessed with knowing its numbers have moved medicine from the bedside to the desktop (or laptop). The art of medicine is becoming the science of an insurance actuary.
(More here.)
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