Reference no: EM1317058

Q1) Read passage below, and then think the following scenario. Physician is trying to choose whether to recommend medication for cholesterol reduction in 45-year-old female patient. Null hypothesis is that patient's cholesterol is less than threshold of treatable hypercholesterolemia. Though, a sample of readings over 2-year time period shows considerable variation, usually below but sometimes above threshold.

Hypercholesterolemia is known risk factor for coronary artery disease. Risk of death from coronary artery disease has continuous and graded relation to total serum cholesterol levels higher than 180 mg/dl. Though, ratio of total cholesterol to HDL cholesterol is better predictor of coronary artery disease than level of either fraction alone. After menopause, plasma LDL cholesterol concentrations increase to equal, and then to exceed, those of men, at same time HDL cholesterol concentrations fall slightly.  This puts women at equal or greater risk for cardiovascular disease. According to results of medical trials, there is compelling evidence that reduction in level of cholesterol leads to noteworthy decline in rate of cardiovascular events. However, screening for high blood cholesterol is important clinical intervention. National Heart, Lung and Blood Institute advises that all persons aged 20 and above have cholesterol determination at least once every 5 years. Timely identification of high-risk individuals permits consideration of different treatment alternatives. For patients who don't have coronary heart disease or peripheral vascular disease, emphasis must be placed on non-pharmacologic approaches, mostly changes in diet and exercise. Drug therapy must be reserved for those at highest risk of coronary heart disease: men above 35 years of age and postmenopausal women.

i) How might patient's point of view vary from HMO's or doctor's?

ii) In what sense is this business problem? A societal problem? An individual problem?