shared decision making; patient preferecnce

Introduction

An approach to making medical decisions that combines a physician's expertice in the medical domain with the patient's knowledge of his/her wishes/values in order to make decisions in the patient's best interest. This approach is especially indicated when evidence about the best management strategy is equivocal.

Notes

• shared decision making can cut antibiotic use in half & improve patient satisfaction
• shared decision making leads to
  • less invasive procedures
  • improved patient satisfaction*
  • lower costs
  • more time spent with each patient
  • less attention paid to quality measures
• use of option grids may facilitate shared decision making
• studies are limited, results are inconsistent, & clinical implications are unclear*
• shared decision-making with lung cancer screening falls short

* patient satisfaction may be associated with worse outcomes

• quality measures conflict with shared decision making
• if outcomes assessed in part by quality measures, association of patient satisfaction with outcomes requires context- dependent interpretation

More general terms

• decision making