Skip to content

Methodology

TherapySelector supports physicians to easily and quickly choose a data-based, personalized treatment for and with their patients during consultation hours.

Patient profile Personalized Medicine

The TherapySelector app is the practical tool of Patient Profile Personalized Medicine, a new form of Personalized Medicine.

Database

The base of TherapySelector is a database of high-quality data from worldwide clinical trials or registrations, which is updated frequently.

Research groups and sponsors worldwide provide anonymous patient data from published randomized controlled trials, other phase 2 & 3 studies and prospective real-life studies.

The database only contains data on registered drugs that can be prescribed by a physician and that have been approved by the FDA, EMA and/or the Dutch Medicines Evaluation Board (MEB).

Methodology

In our database, the individual patient data from studies are converted into a so-called 'patient profile', 'therapy regimen' and 'therapy outcome'.

The patient profile is based on four characteristics of a patient: one from each of the categories of etiology/pathophysiology, disease stage, previous treatments and comorbidities. These four characteristics co-determine the effectiveness of the treatment. For each disease there are easily 200 unique patient profiles.

The therapy regimen includes the characteristics of the therapy given: therapy name, dosage, and duration.

The therapy outcome currently concerns the short-term outcome: disease remission (systolic blood pressure of < 140 mm Hg for hypertension).

Subsequently, for each of these patient profile therapy regimens, the 'success' rate for the various treatment regimens is calculated. The Per-Protocol (PP) population is used; these are the patients with an outcome measure.

In the selection of publications and in the processing of individual patient data, great care is taken to minimize all kinds of bias. For this reason, studies involving fewer than 8 patients on a specific treatment regimen are not included.

Results

As a doctor you can view the information from the database with the TherapySelector app.

First you enter the four characteristics of your patient. The app then shows at a glance an overview of all registered treatments for that specific patient profile, and additionally the associated information about effectiveness, adverse events and costs.

The order of results is determined on the basis of effectiveness, percentage of adverse events, patient group size and cost according to a weighting method (Van Breukelen, Ned Tijdschr Geneeskd. 2000;144:1580-4, Hoe te komen tot een gewogen totaalscore van afzonderlijke scores).

TherapySelector has developed this weighting method - independent of the pharmaceutical industry - for the specific disease, which has been authorized by the editor on behalf of the scientific associations. Here effectiveness and adverse events weigh most heavily, cost and patient group size weigh less heavily. Results with patient profiles < 40 patients are always listed below results of patient profiles with more reliable results.

Adverse events are reported if such events are clinically relevant due to their severity (FDA or EMA warnings), or occur at a higher frequency than in placebo-controlled clinical trials.

Information about costs has been obtained from an objective Dutch source (https://www.farmacotherapeutischkompas.nl/). These costs are comparable in many European countries; for costs in the USA, please refer to https://www.drugs.com/.

Collaboration and validation

The app is being developed by TherapySelector in collaboration with physicians and scientists associated with leading academic medical centers such as Erasmus MC, LUMC and MUMC+.

The data in the app is authorized by specialists on behalf of national scientific associations, including the Dutch Hypertension Association (NHV) and Dutch Association for Hepatology (NVH).

The app is CE marked in accordance with the EU directive 93/42/EEC.

Logo Erasmus University Medical Centre
Logo Leiden University Medical Center
Logo Maasticht University Medical Centre
Logo Nederlandse Hypertensie Vereniging

Hypertension

For primary hypertension, patient profiles are based on the following characteristics:

  • Etiology: age and ethnic background
  • Disease stage: chronic with or without organ damage (heart, brain, kidney) and systolic blood pressure of ≥160 mmHg.
  • Previous treatment: no previous therapy, monotherapy or dual combination therapy, triple or more combination therapy
  • Comorbidity: diabetes & obesity (BMI > 30), diabetes, obesity, no comorbidity

 

For an informed choice of therapy, information on blood pressure control (BPC%), adverse events (AE%), cost (€ (NL)) and group size (QoE) is shown.

For blood pressure control, by default we show the percentage of patients with effective therapy (systolic blood pressure of < 140 mm Hg) after 6 months. For adverse events, the percentage of patients with reported specific antihypertensive drug adverse events is shown. Cost is the cost in the Netherlands over 6 months. Group size is the number of patients within the chosen patient profile.

Cumulative results with treatment schedule

For therapies with a titrate and/or add regimen, a cumulative success rate is shown for each regimen step.

Here, the numerator concerns: the number of patients who were successful with the respective step (e.g. lisinopril 20 mg) plus the number of patients who were successful with a previous step (e.g. lisinopril 10 mg). The denominator refers to: the total of all patients assigned to the treatment regimen in question (the total regimen population, e.g. lisinopril 10, 20 and 40 mg).

When pooling multiple studies with regimens with partly the same steps, it is therefore possible that the number of patients may be different for deviant regimen steps (e.g., for lisinopril 40 mg, because this step was examined in only one of the two studies).

We are here for you

Contact us via
info@therapyselector.nl

Where to find us

Leeuwenstraat 9, 3011 AL
Rotterdam, the Netherlands

Stay up to date?