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Time to benefit: How Long Will It Take for a Test or Treatment to Help Your Patient

Time to benefit is the time between the intervention (usually a test or treatment) and the prevention of an adverse health outcome.

The following figure shows which interventions your patient may benefit from and which may be harmful based on your patient’s life expectancy and the time to benefit from each intervention.

Instructions:

Adjust life expectancy using the orange slider.

green Generally recommended

red Generally not recommended

  1. To prevent major cardiovascular events including death
  2. To prevent major cardiovascular events. The data for statin benefit for primary prevention is limited for patients over age 75
  3. To prevent dialysis and retinopathy (<8 years for most patients). The guideline is primarily supported by the United Kingdom Prospective Diabetes Study (UKPDS)
  4. To prevent a hip fracture
  5. To prevent death from colorectal cancer
  6. To prevent death from breast cancer.
  7. To prevent death from breast cancer. For those women with a history of higher-risk breast cancers such as stage II-III triple negative or ERBB2 positive breast cancers the threshold is 5 years rather than 10 years.

Citations:

Cardiovasular:

Rationalizing prescribing for older patients with multimorbidity: considering time to benefit.
Holmes HM, Min LC, Yee M, Varadhan R, Basran J, Dale W, Boyd CM.
Drugs Aging. 2013 Sep;30(9):655-66. doi: 10.1007/s40266-013-0095-7. Review.
PMID: 23749475

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians
Amir Qaseem, Timothy J. Wilt, Robert Rich, Linda L. Humphrey, Jennifer Frost, and Mary Ann Forciea
Annals of Internal Medicine 2017 166:6, 430-437

Yourman LC, Cenzer IS, Boscardin WJ, et al. Evaluation of Time to Benefit of Statins for the Primary Prevention of Cardiovascular Events in Adults Aged 50 to 75 Years: A Meta-analysis. JAMA Intern Med. 2021;181(2):179–185. doi:10.1001/jamainternmed.2020.6084

Endocrine:

King P, Peacock I, Donnelly R. The UK prospective diabetes study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol.
1999;48(5):643-648. doi:10.1046/j.1365-2125.1999.00092.x

Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate. van de Glind EM, Willems HC, Eslami S, et al. Drugs Aging. 2016;33(5):347-353. doi:10.1007/s40266-016-0344-7

Cancer:

Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. Lee SJ, Boscardin WJ, Stijacic-Cenzer I, Conell-Price J, O'Brien S, Walter LC.
BMJ. 2013 Jan 8;346:e8441. doi: 10.1136/bmj.e8441. PMID: 23299842

Time to benefit for colorectal cancer screening: survival meta-analysis of flexible sigmoidoscopy trials.
Tang V, Boscardin WJ, Stijacic-Cenzer I, Lee SJ.
BMJ. 2015 Apr 16;350:h1662. doi: 10.1136/bmj.h1662. Erratum in: BMJ. 2015;350:h2228.
PMID: 25881903

Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (ACP)
Amir Qaseem, Carolyn J. Crandall, Reem A. Mustafa, Lauri A. Hicks, and Timothy J. Wilt
Annals of Internal Medicine 2019 171:9, 643-654

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians (ACP)
Amir Qaseem, Jennifer S. Lin, Reem A. Mustafa, Carrie A. Horwitch, and Timothy J. Wilt
Annals of Internal Medicine 2019 170:8, 547-560

Freedman RA, Minami CA, Winer EP, et al. Individualizing Surveillance Mammography for Older Patients After Treatment for Early-Stage Breast Cancer: Multidisciplinary Expert Panel and International Society of Geriatric Oncology Consensus Statement. JAMA Oncol. Published online January 28, 2021.
doi:10.1001/jamaoncol.2020.7582

DISCLAIMER

The information provided on ePrognosis is designed to complement, not replace, the relationship between a patient and his/her own medical providers. ePrognosis was created with the support of the Division of Geriatrics at the University of California San Francisco. However, its content is strictly the work of its authors and has no affiliation with any organization or institution. This web site does not accept advertisements. If you reproduce the material on the website please cite appropriately. For feedback and questions regarding the site please email Sei Lee, MD (sei.lee@ucsf.edu), Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu).