Marisa Cruz, MD
“It's an easily usable simple model with only 12 factors. The clinician can ask the patient ‘yes’ or ‘no’ questions about his or her health and functional status and then can then go over how the patient could benefit from certain medical interventions,” Cruz said.
The ability to complete cognitive or motor skills such as managing one’s finances or walking several blocks also was factored into the equation. The difficulty in performing each aptitude generated one to two points.
“The goal of the study is to build a clinical tool that can be used in any setting,” Cruz said. “So you want to have these kinds of models to be able to be generally applicable to a primary care provider no matter where they are.”
Sei Lee, MD, MAS
This current research builds on a study that senior author Sei Lee, MD, MAS, assistant professor with the UCSF Division of Geriatrics, did in 2006. He and his team looked at factors that were most likely to influence intermediate term life expectancy.
“We looked at things like what factors are most predictive of someone's likelihood of surviving for four years,” he said. “The new study takes that research even further by helping doctors be able to counsel patients on what clinical interventions are most likely to benefit them.”
A National Sample
Researchers could not determine any difference in outcome based on geography or ethnicity. Theoretically, someone from Louisiana would have the same outcome as someone from Maine with similar risk factors.
“The goal of health care in general is to improve people's lives but I think that this project and this model in particular are meant to be able to make sure that people live the highest quality life they can,” Cruz said. “Any interventions that we do in the name of promoting health must yield more benefit than harm.”
“There are national guidelines that most providers are very familiar with like getting a colonoscopy every 10 years or getting a mammogram every two years. I think those are excellent and well-founded and well-studied guidelines,” Cruz said. “But I do think that there are some variability in tailoring that to your particular situation, so there's benefit to engaging your primary care provider and asking, ‘Does this make sense for me?’”
Cruz is the first author of the paper; Lee is the senior author; co-authors include Kenneth Covinsky, MD, MPH; Eric W. Widera, MD; and Irena Stijacic-Cenzer of the UCSF Division of Geriatrics. Their findings were published March 5th in the Journal of the American Medical Association (JAMA). This study was supported by the American Federation for Aging Research and the National Institute on Aging through the Beeson Career Development Award (K23AG040779) and a grant (K24AG029812). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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