Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundMedical treatment decisions are often based on estimated global risk scores.
When heterogeneity in treatment effects exists, assigning treatment according to estimated individualized treatment rules (ITRs) instead has the potential to improve mean outcomes. This article aims to investigate racial and ethnic group differences in treatment rates when comparing antihypertensive medication recommendations from an estimated ITR with a risk score approach.MethodsData were simulated to emulate observational data with underlying treatment effect heterogeneity in survival times.
An ITR and risk score approach were compared to illustrate how the resulting recommendations may disagree. An ITR for prescribing antihypertensives was estimated from 3281 adults from MESA (Multi‐Ethnic Study of Atherosclerosis), an observational longitudinal cohort study, and compared with the risk‐based approach recommended by cardiovascular care guidelines.
Hypothetical treatment rates under each “rule” were computed. In the simulation study, the proportion of individuals treated optimally under each rule was calculated.
Journal of the American Heart Association published a clinical update in Cardiology on 04 Mar 2026.
The item focuses on Health Equity Perspective on Data‐Driven Treatment Decisions in Cardiovascular Care: Risk Assessments Versus Individualized Treatment Rules.
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