Evidence in context: Why biology and biography matter for personalized carePublished Jan 28 2019, 3:50 PM
By Samantha Noderer, MA, OptumLabs, Patient Journeys and the Future of Health Care Series
Our partners from Mayo Clinic are putting evidence that matters to patients at the center of decision-making. Real-world data from OptumLabs helps the cause.
Behind the doors of the Mayo Clinic Shared Decision-Making National Resource Center in Rochester, Minnesota, there’s a revolution brewing. A team is working to achieve the ideal of evidence-based medicine: when a doctor’s clinical expertise and a patient’s personal experience combine to inform care.
The center develops, tests and implements shared decision-making tools to help doctors compare treatments and choose the best option with their patient. This requires a combination of the clinician’s knowledge about disease, tests and treatments and the patient’s perspective about their own body, circumstances and life goals. According to the center director, Victor Montori, MD, MSc, the most fundamental measure of success is “when patients walk away feeling they know enough about their options, that the option they chose is the best for their personal circumstance, and they are willing and able to act on that decision.”
Aligning with our theme of Patient Journeys and the Future of Health Care, Dr. Montori delivered a keynote presentation on this patient revolution at the OptumLabs Research & Translation Forum — our annual partner event — this past November.
Watch now: “A Patient Revolution for Careful and Kind Care” – Victor Montori, Mayo Clinic
Dr. Montori told a story about an older woman who struggles to manage all of her medications, devices and doctor’s visits for multiple chronic conditions while living alone. The kind of health care that Dr. Montori advocates for “weaves the work of being a patient with the work of life.” To do this, physicians must understand not only the biology of a patient, but their biography — including their lifestyle, support system and values. The right treatment should strike a balance between being clinically effective and minimally invasive in a patient’s daily life. When treatment options are presented in the context of existing clinical evidence as well as patient biography, “evidence-based care” is transformed into “evidence-based care.”
Mayo Clinic decision aids leverage evidence from different types of research. These include insights from clinical trials, observational studies and patient advisory groups. In one case, OptumLabs data, which includes de-identified claims and medical record data for tens of millions of commercial and Medicare Advantage enrollees, has enabled two Mayo Clinic researchers to do real-world comparisons of stroke prevention treatments in patients with atrial fibrillation (you can learn about some of the research in their blog post). These insights are contributing to a new anticoagulation choice decision aid.
At the R&T Forum, Peter Noseworthy, MD, cardiac electrophysiologist, and Xiaoxi Yao, PhD, MPH, health outcomes researcher, discussed why clinical trial results alone are often not enough to guide treatment for a patient, and how large observational data ― like the OptumLabs data ― can help translate trials and personalize treatment decisions in the real world. They used the scenario of choosing catheter ablation in patients with atrial fibrillation as a case study in a group polling exercise.
Watch now: “Putting Research from OptumLabs Data into Practice: Personalizing the Treatment of Atrial Fibrillation” – Peter Noseworthy and Xiaoxi Yao, Mayo Clinic
If you look up the philosophy of the Mayo Clinic Share Decision-Making National Resource Center, it’s summed up by a quote from W.J. Mayo, MD, one of the founders of the Mayo Clinic: “The best interest of the patient is the only interest to be considered.”
At OptumLabs, we’re honored to support this vision through our research partnership that helps to put “care” front and center in the empathetic approach to shared decision-making.
To learn more, visit www.patientrevolution.org.
ABOUT THE AUTHOR
Samantha Noderer, MA, is the communications and translation manager at OptumLabs.