Thursday, December 31, 2015

Quantification of Medical Treatments: TREATMENT SCORES

The bar for understanding medical treatments is very low. A recent study of 531 physicians showed that the majority of physicians (over 80% in some cases) don’t understand treatment effects.[1] What this means is that nearly all patients don’t understand treatments. We have the blind leading the blind.

Why so much confusion? Because the math is hard.

When you are given a list of treatments for your disease you need to see the Treatment Score for each treatment. But you never do. Why not? Because Treatment Scores represent the “net absolute treatment benefit” in the literature, and the mathematics of determining the “net absolute treatment benefit” from medical studies is very difficult. Therefore, very little useful quantification of treatments is done today.

What is the quantification today? Today, the evidence behind treatments is sometimes quantified into three categories:
  1. Likely beneficial
  2. Likely harmful
  3. We can’t tell

We must do better than this because people’s lives are literally at stake. People’s lives, your health, permanent side effects, and resulting disabilities all come into play. In fairness, some systems try to be a little bit more helpful by sticking in extra categories that can be paraphrased as “really likely to be beneficial,” “really unlikely to be beneficial,” and “sometimes beneficial and sometimes harmful,” which gives people six vague categories instead of three vague categories.

We need to know if statistics suggest the “net absolute treatment benefit” is 1% or 99%, or somewhere in between. We need Treatment Scores.

With the tools at TreatmentScores.com, we are quantifying the science of medicine behind treatments from 0 to 100. We are also separating treatments into grades A, B, C, D, and E (using a 20-point range for each). Grade F is reserved for things that appear harmful.

If you undergo a cancer treatment, is it a grade A treatment score? If you take statins for high cholesterol is that a grade A treatment score or a grade E treatment score? What about the 130 treatments for insomnia? What about the 57 treatments for acute migraine headache?

We are parsing our words. We are looking at what the evidence behind a treatment is; we are not recommending or rating the treatments themselves. That is up to your experienced medical professional. We are producing the starting point for shared-decision making using the evidence in the medical literature. See our disclaimers at the bottom.

We think it is time to go from vague “treatment quantification” to more helpful Treatment Scores and Treatment Grades.

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DISCLAIMERS: You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

Copyright
Copyright © 2015 Treatment Scores, Inc.

Sources
[1] "Do clinicians understand the size of treatment effects? A randomized survey across 8 countries." Bradley C. Johnston, Pablo Alonso-Coello, et al. CMAJ October 26, 2015.
http://www.cmaj.ca/content/early/2015/10/26/cmaj.150430


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