Physicians spend a lot of time treating numbers - blood pressure, cholesterol levels, gly-cated hemoglobin levels. Professional guidelines, pharmaceutical marketing, and public health campaigns teach physicians and patients that better numbers mean success. Unfortunately, better numbers don't reliably translate into what really matters: patients who feel better and live longer. Often the health benefit gained by reaching a goal depends on how it is reached. When physicians strive for numerical goals without prioritizing the possible treatment strategies, patients may get less effective, less safe, or even unnecessary medications. Many quality measures reinforce a focus on numerical goals. For example, performance-measure targets for hypertension control, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) and the Physician Quality Reporting System (PQRS), are met if a blood pressure below 140/90 mm Hg is reached after treatment with any antihyperten-sive medication, without a trial of dietary and exercise interventions (see table). Medications are the quickest and easiest way to reach the goal. Targets for cholesterol-control measures are met if a low-density lipoprotein (LDL) cholesterol level below 100 mg per deciliter is achieved in patients with coronary artery disease using ezetimibe before trying sim-vastatin, even though only the latter has been shown to reduce myocardial infarction risk.
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机译：医师花费大量时间来处理数字-血压，胆固醇水平，糖化血红蛋白水平。专业指南，药品营销和公共卫生运动向医生和患者传达了更好的数字意味着成功。不幸的是，更好的数字不能可靠地转化为真正重要的事情：感觉更好，寿命更长的患者。通常，通过实现目标所获得的健康益处取决于实现目标的方式。当医生为实现数字目标而没有优先考虑可能的治疗策略时，患者可能会得到无效，安全性降低甚至不必要的药物治疗。许多质量度量加强了对数字目标的关注。例如，如果治疗后血压达到140/90 mm Hg以下，则可以达到由医疗保健有效性数据和信息集（HEDIS）和医师质量报告系统（PQRS）定义的控制高血压的绩效指标。无需尝试饮食和运动干预即可使用任何降压药（见表）。药物是达到目标的最快，最简单的方法。如果在使用辛伐他汀之前使用依泽替米贝治疗患有冠心病的患者低密度脂蛋白（LDL）胆固醇水平达到每分升100 mg以下，胆固醇控制措施的目标就可以实现，即使只有后者可以降低胆固醇心肌梗塞的风险。
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