%0 Journal Article %J Medical decision making : an international journal of the Society for Medical Decision Making %D 2011 %T Can life expectancy and QALYs be improved by a framework for deciding whether to apply clinical guidelines to patients with severe comorbid disease? %A Braithwaite, R Scott %K Blood Glucose %K Colorectal Neoplasms %K Comorbidity %K Female %K Humans %K Life Expectancy %K Middle Aged %K Models, Theoretical %K Practice Guidelines as Topic %K Quality-Adjusted Life Years %N 4 %P 582-95 %R 10.1186/1758-2652-14-38 %V 31 %X Guidelines with short-term harms and long-term benefits are often applied to chronically ill patients who may not benefit. The payoff time framework has been proposed (i.e., do not apply a guideline if a patient's life expectancy (LE) is shorter than when a guideline's cumulative incremental benefits first exceed its cumulative incremental harms), but its health impact is unclear. %8 2011 Jul-Aug