Fred (Michael) M. Cutrer, M.D.

Fred (Michael) Cutrer, M.D., a headache neurologist at Mayo Clinic, saw an opportunity to improve the current system and began development of the Next Best Drug algorithm.

Trained using anonymized data from thousands of patients who went through the long process of finding effective treatment for their chronic migraines, and incorporating Dr. Cutrer’s extensive expertise in headache neurology, the algorithm is a clinical decision support tool currently designed as a resource for non-specialist medical practitioners choosing which medication to try next for their own patients going through the process of finding migraine relief.

To use this tool, the patient must first complete a headache profile that includes headache symptoms, details of previous medications tried and why they failed. Because migraine medications may take months to have an effect, the algorithm also evaluates whether medications that failed to be effective were used long enough and at an appropriate dose for treating headaches before dismissing those drugs as options.

The Next Best Drug algorithm then takes the patient’s headache profile and medical record and creates a personalized, prioritized list of recommendations for the next best drug for that patient to try. While this tool could be helpful for experienced headache neurologists, Dr. Cutrer sees particular promise as a tool for neurologists and primary care providers without specialized expertise. If a primary care provider is able to find a medication that effectively manages a patient’s symptoms in fewer drug trials and without the need to refer to a specialist, it would mean fewer appointments, fewer months trialing medication, fewer days in pain, and more availability for new patients.