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A new framework to build onKerr and her colleagues from Michigan Medicine, U-M’s academic medical center, and the VA Ann Arbor Healthcare System emphasize that their new paper sets out a framework for future efforts by guideline developers to offer specific guidance on right-sizing care.
The initial set of recommendations is tailored for adult primary care. But the authors hope that the professional societies that create treatment guidelines will be able to adopt their approach to more precisely frame future recommendations to encompass not only when to start treatments or screening, but also when to stop or scale them back.
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For instance, as people with diabetes get older, they don’t need to take multiple medications to lower their blood sugar or blood pressure to the same target number they aimed for when they were younger. That’s because the evidence that supports those low targets comes from studies that focused on preventing diabetes-related problems decades in the future. Plus, older patients are at higher risk from low blood sugar that these medications may cause.
Or, in another example, men who have been used to getting a periodic blood test …
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