This article examines a framework to indicate when patients with comorbid illness are more or less likely to benefit from colorectal cancer screening practice guidelines. The study hypothesizes that patients with chronic diseases might not survive long enough to gain from medical practice guidelines that have immediate risks and delayed benefits.
The authors first established the “payoff time” for three typical patients: the minimum length of time at which the benefits of screening for colorectal cancer exceeded the risk to the patient. They then assessed whether each patient would benefit from colorectal cancer screening based on their estimated life expectancy.
Determining the minimum time at which a practice guideline's benefit outweighs its costs may help physicians determine when patients are unlikely to be helped by a specific guideline.