# Patient profiled data for treatment decision-making: valuable as an add-on to hepatitis C clinical guidelines?

## TL;DR

A new tool called TherapySelector was tested to improve hepatitis C treatment decisions by using updated data and patient profiles.

## Contribution

TherapySelector, an add-on to clinical guidelines, was evaluated for its ability to guide hepatitis C treatment based on updated evidence and patient profiles.

## Key findings

- Use of TherapySelector increased from 27% in 2015 to 60% in 2020.
- Many patients received longer treatments or added ribavirin despite lower benefits.
- The tool had minimal impact on cure rates but reduced adverse effects and costs.

## Abstract

Systematic reviews and medical guidelines are widely used in clinical practice. However, these are often not up-to-date and focussed on the average patient. We therefore aimed to evaluate a guideline add-on, TherapySelector (TS), which is based on monthly updated data of all available high-quality studies, classified in specific patient profiles.

We evaluated the TS for the treatment of hepatitis C (HCV) in an international cohort of patients treated with direct-acting antivirals between 2015 and 2020. The primary outcome was the number of patients receiving one of the two preferred treatment options of the HCV TS, based on the highest level of evidence, cure rate, absence of ribavirin-associated adverse effects, and treatment duration.

We enrolled 567 patients. The number of patients treated with one of the two preferred treatment options according to the HCV TS ranged between 27% (2015) and 60% (2020; p < 0.001). Most of the patients received a regimen with a longer treatment-duration (up to 34%) and/or addition of ribavirin (up to 14%). The effect on the expected cure-rate was minimal (1–6% higher) when the first preferred TherapySelector option was given compared to the actual treatment.

Medical decision-making can be optimised by a guideline add-on; in HCV its use appears to minimise adverse effects and cost. The use of such an add-on might have a greater impact in diseases with suboptimal cure-rates, high costs or adverse effects, for which treatment options rely on specific patient characteristics.

The online version contains supplementary material available at 10.1186/s12911-024-02608-x.