Annals of internal medicine Current Author Addresses: Drs. Hlatky, Boothroyd, Baker, and APPENDIX: EXAMPLES OF INDIVIDUALIZED ESTIMATES OF silane: Stanford University School of Medicine, HRP Redwood Build- TREATMENT EFFECTIVENESS g, 259 Campus Drive, Stanford, CA 94305-5405 7e estimated individualized changes in life expectancy after Dr. Kazi: UCSF Division of Cardiology, San Francisco General Hospi- CABG rather than PCI by using a Cox proportional hazards al, 1001 Potrero Avenue, SGl, San Francisco, CA 94110. Drs. Solomon and Go: Division of Research. Kaiser Permanente north- model with 13 covariates: age, sex, race, diabetes, tobacco use, ern California, 2000 Broadway, Oakland, CA 94612 chronic kidney disease, peripheral vascular disease, cerebrovascu Dr. Chang: Stanford University School of Medicine, Nephrology Divi- lar disease, prior MI, heart failure, unstable angina, atrial fibril- sion, 777 Welch Road, Room D100, Palo Alto, CA 94304 ation,and a primary diagnosis of MI at the same hospitalization as the revascularization procedure. Individualized treatment esti- mates as a function of these variables will be made available on Author Contributions: Conception and design: M.A. Hlatky, L. Baker A.S. Go aWebsitethepossibleformatofwhichcanbeseenathttp Analysis and interpretation of the data: M.A. Hlatky, D B. Boothroyd //med. stanford. edu/hsr/cabg-pci. Example patients are described D.S. Kazi, M.D. Solomon, T.I. Chang, D. Shilane, A.S. Go. Drafting of the article: M.A. Hlatky Example 1: A 70-year-old black man with diabetes and pe ritical revision of the article for important intellectual content: D.B. ripheral vascular disease but no tobacco use or heart failure. The Boothroyd, D.S. Kazi, M D. Solomon, T.L. Chang, D. Shilane, A.S. Go. median number of life-years added over 5 years by CABG among Final approval of the article: M.A. Hlatky, D B. Boothroyd, L. Baker, 43 similar patients in the data set was 0.079(range, 0.067 to D.S. Kazi, M.D. Solomon, T.I. Chang, D. Shilane, A.S. Go. Provision of study materials or patients: L. Baker. 0. 139 life-years) Statistical expertise: M.A. Hlatky, D B. Boothroyd, D. Shilane. Example 2: A 75-year-old white woman with diabetes but Obtaining of funding: M.A. Hlatky, A.S. Go ithout heart failure, peripheral vascular disease, or tobacco use. Administrative, technical, or logistic support: M.A. HLatky, L. Baker. The median number of life-years added over 5 years by CABG Collection and assembly of data: D B. Boothroyd, L. Baker. among 2267 similar patients in the data set was 0.007(range, 0.005 to 0.133 life-years) agnosis of acute MI. The median number of life-years added over 5 years by CABG among 2596 similar patients in the data set was -0.014(range, -0.012 to -0.028 life-years)(that is, the pre- dicted survival was better with PCI Example 4: A 77-year-old white woman with diabetes, pe ripheral vascular disease, and heart failure but no tobacco use. The median number of life-years added over 5 years by CABG among 176 similar patients in the data set was 0. 286(range, 0. 211 to 0.502 life-years w-302 21 May 2013 Annals of Internal Medicine 158.Number www.annals.orgCurrent Author Addresses: Drs. Hlatky, Boothroyd, Baker, and Shilane: Stanford University School of Medicine, HRP Redwood Build￾ing, 259 Campus Drive, Stanford, CA 94305-5405. Dr. Kazi: UCSF Division of Cardiology, San Francisco General Hospi￾tal, 1001 Potrero Avenue, SG1, San Francisco, CA 94110. Drs. Solomon and Go: Division of Research, Kaiser Permanente North￾ern California, 2000 Broadway, Oakland, CA 94612. Dr. Chang: Stanford University School of Medicine, Nephrology Divi￾sion, 777 Welch Road, Room D100, Palo Alto, CA 94304. Author Contributions: Conception and design: M.A. Hlatky, L. Baker, A.S. Go. Analysis and interpretation of the data: M.A. Hlatky, D.B. Boothroyd, D.S. Kazi, M.D. Solomon, T.I. Chang, D. Shilane, A.S. Go. Drafting of the article: M.A. Hlatky. Critical revision of the article for important intellectual content: D.B. Boothroyd, D.S. Kazi, M.D. Solomon, T.I. Chang, D. Shilane, A.S. Go. Final approval of the article: M.A. Hlatky, D.B. Boothroyd, L. Baker, D.S. Kazi, M.D. Solomon, T.I. Chang, D. Shilane, A.S. Go. Provision of study materials or patients: L. Baker. Statistical expertise: M.A. Hlatky, D.B. Boothroyd, D. Shilane. Obtaining of funding: M.A. Hlatky, A.S. Go. Administrative, technical, or logistic support: M.A. Hlatky, L. Baker. Collection and assembly of data: D.B. Boothroyd, L. Baker. APPENDIX: EXAMPLES OF INDIVIDUALIZED ESTIMATES OF TREATMENT EFFECTIVENESS We estimated individualized changes in life expectancy after CABG rather than PCI by using a Cox proportional hazards model with 13 covariates: age, sex, race, diabetes, tobacco use, chronic kidney disease, peripheral vascular disease, cerebrovascu￾lar disease, prior MI, heart failure, unstable angina, atrial fibril￾lation, and a primary diagnosis of MI at the same hospitalization as the revascularization procedure. Individualized treatment esti￾mates as a function of these variables will be made available on a Web site, the possible format of which can be seen at http: //med.stanford.edu/hsr/cabg-pci. Example patients are described below. Example 1: A 70-year-old black man with diabetes and pe￾ripheral vascular disease but no tobacco use or heart failure. The median number of life-years added over 5 years by CABG among 43 similar patients in the data set was 0.079 (range, 0.067 to 0.139 life-years). Example 2: A 75-year-old white woman with diabetes but without heart failure, peripheral vascular disease, or tobacco use. The median number of life-years added over 5 years by CABG among 2267 similar patients in the data set was 0.007 (range, 0.005 to 0.133 life-years). Example 3: A 66-year-old white man without diabetes, heart failure, peripheral vascular disease, tobacco use, or a primary di￾agnosis of acute MI. The median number of life-years added over 5 years by CABG among 2596 similar patients in the data set was
0.014 (range,
0.012 to
0.028 life-years) (that is, the pre￾dicted survival was better with PCI). Example 4: A 77-year-old white woman with diabetes, pe￾ripheral vascular disease, and heart failure but no tobacco use. The median number of life-years added over 5 years by CABG among 176 similar patients in the data set was 0.286 (range, 0.211 to 0.502 life-years). Annals of Internal Medicine W-302 21 May 2013 Annals of Internal Medicine Volume 158 • Number 10 www.annals.org