How patients make medical decisions
January 28, 2014
ANN ARBOR—Sooner or later, everyone faces decisions about whether or not to have surgery, take a new medication, or have a cancer-screening test. A new study published in Health Expectations explores the costs and benefits patients say are important in making these kinds of medical decisions, and how those costs and benefits explain what they actually decide to do.
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“Many decisions in life can be understood in terms of people’s assessments of costs and benefits, and this study finds that this is also true of medical decisions,” says Eleanor Singer, a researcher at the University of Michigan Institute for Social Research (ISR) and the lead author of the study.
For the study, Singer and colleagues surveyed 3010 English-speaking adults ages 40 and older who reported having made a medical decision within the last two years.
“The importance attached to specific costs and benefits varies greatly from one person to another,” says Singer. “For example, in discussing a decision about surgery, one patient may give high importance to being able to function better, but may attach even greater importance to the possibility of serious side effects. For another patient, this calculus may be reversed.”
The study also found that while patient assessment of costs and benefits predicts what they decide to do, it does not necessarily indicate that they are well-informed.
“So physicians must take time to discover not only how a particular patient facing a particular decision evaluates its specific benefits and costs, but also whether perceptions of benefits and costs are accurate.” Only then, Singer says, can truly informed shared decision making come about.
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By Diane Swanbrow