How patients make medical decisions

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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. Eleanor Singer

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 University of Michigan 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.

"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," said Eleanor Singer, a researcher at the U-M Institute for Social Research and lead author of the study.

Singer and colleagues surveyed 3,010 English-speaking adults ages 40 and older who reported having made a medical decision within the last two years.

"A doctor meets with a couple at the hospital. (stock image)The importance attached to specific costs and benefits varies greatly from one person to another," Singer said. "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," Singer said.

Only then, she says, can truly informed shared decision-making come about.

 

Established in 1949, the University of Michigan Institute for Social Research is the world's largest academic social science survey and research organization, and a world leader in developing and applying social science methodology, and in educating researchers and students from around the world. ISR conducts some of the most widely cited studies in the nation, including the Thomson Reuters/University of Michigan Surveys of Consumers, the American National Election Studies, the Monitoring the Future Study, the Panel Study of Income Dynamics, the Health and Retirement Study, the Columbia County Longitudinal Study and the National Survey of Black Americans. ISR researchers also collaborate with social scientists in more than 60 nations on the World Values Surveys and other projects, and the institute has established formal ties with universities in Poland, China and South Africa. ISR is also home to the Inter-University Consortium for Political and Social Research, the world's largest digital social science data archive. For more information, visit the ISR website at www.isr.umich.edu.

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