The proliferation of detailed clinical guidelines created by government agencies and professional organizations across the globe has increasingly guided patient treatment in recent years. Most physicians and medical assistants now use such guidelines -- which are based on the results derived from examining extremely large groups of patients -- to routinely assess conditions and risk factors for average persons.

There may be a problem with that, as evidenced by the misdiagnosis of an illness in many instances and less than optimal treatment results for millions of people: "Average" is an elusive concept, and the shortcomings of a strategy that posits the validity of set variables and outcomes for virtually all people manifesting the same symptoms are now being demonstrated by new and sophisticated research.

Guidelines are commonly used for many reasons. They are simple (e.g., treat diabetics with drugs when their systolic blood pressure is 140 or above) and they are systematically codified. And now, increasingly, rigidly adhering to them is seen as best medical practice, with many doctors balking at following another regimen owing to potential monetary and legal risk.

New research that applies previously unavailable mathematical models is now being used by researchers that allows for more sophisticated and meaningful guidelines that enable better differentiation among patient and promise a more personally tailored treatment.

Archimedes Inc., a health care company from San Francisco, has recently completed research that tips standard views concerning current guidelines on their head. Specifically, the company has found that patients who receive care based on commonly accepted guidelines actually have higher rates of heart attack and stroke than do those who are cared for through a more person-specific and individualized guideline. Additionally, the latter type of treatment costs considerably less.

Archimedes believes that new technology makes entering patient data and making relevant calculations easier than ever before, especially with the advent of electronic medical records. The hopeful result is that doctors and medical facilities will be able to integrate these records with newer and more intricate guidelines that allow for more creativity and flexibility in treating specific patients.

The lead author of Archimedes' report calls this "the way of medicine in the future," adding that, "Now we have the tools to move to the next generation of guidelines."

Related Resource: New York Times, "Finding the Patient in a Sea of Guidelines" May 19, 2011