Goal-directed therapy may improve outcome in complex patients – depending on the chosen treatment end point

Excerpt

One of the greatest opportunities to improve patient outcomes comes not from discovering new treatments, but using existing therapies more effectively [1]. Health services research is a relatively new academic discipline based on the study of methods of delivering healthcare safely, effectively, and efficiently. Emphasis is placed on systems and processes of healthcare delivery, on team performance, and on patient pathways and, above all, on patient outcome rather than on single interventions such as use of a new drug with narrowly defined endpoints. Health services research does fit comfortably alongside traditional academic science which many medical researchers see as occupying the high-ground of scientific discovery. Perhaps as a result of such perceptions, funding of health services research is minimal compared to the funding allocated to basic science and traditional clinical research [1]. However health services research has a particularly important role to play in ensuring cost-effective delivery of care in resource-limited healthcare systems. Inexpensive interventions can prove to be as effective if not more effective than some expensive or technically complex solutions. There is, however, a danger that commercial and academic vested interests continue to promote new products and innovations and their associated costly research programmes, whilst ignoring the benefits that might accrue from revisiting “old” therapies. …