comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients比较高脂血症的管理指南的有效性和2型糖尿病的高血压患者.pdfVIP

Comparative Effectiveness of Guidelines for the Management of Hyperlipidemia and Hypertension for Type 2 Diabetes Patients 1,2 4 3 1,4 3 Nilay D. Shah *, Jennifer Mason , Murat Kurt , Brian T. Denton , Andrew J. Schaefer , Victor M. Montori1,2,5, Steven A. Smith1,2,5 1 Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, United States of America, 2 Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, Minnesota, United States of America, 3 Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America, 4 Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America, 5 Division of Endocrinology, Mayo Clinic, Rochester, Minnesota, United States of America Abstract Background: Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. Methods and Findings: Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40–80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT) to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent