Title: Communicating evidence for participatory decision making.
Abstract: Communicating evidence for participatory decision making. Epstein RM, Alper BS, Quill TE. JAMA. 2004; 291(19):2359-2366. Contemporary health care practice and curricula strive to use clinical evidence to determine best practice. With the goal of increasing the patient's ability to participate in and make informed decisions about their care, this study reports the results of a systematic review of the literature regarding the most effective means of communicating to patients evidence from medical literature. A systematic review of MEDLINE from 1996 to 2003 produced eight articles relevant to the search parameters of communication and methods of presenting clinical evidence to patients, which included nonquantitative descriptive terms, numerical translation of study results, graphic representations, and aids in the decision making process. Although the researchers were unable to draw conclusions about the most effective methods to communicate contemporary evidence to patients, an analysis of the literature did provide insight into how information is perceived by patients. The order or the format in which information is presented was reported to bias a patient's interpretation, thus impacting the decision-making process. Therefore, clinicians should be cognizant of their own biases when educating patients about clinical evidence. Decision aids are effective in facilitating the shared decisionmaking between physicians and their patients, thereby serving to decrease some of the bias that can enter into the decision-making process. While there is limited evidence to direct the interaction between physicians and patients, the researchers were able to develop communication guidelines to facilitate effective shared clinical decision making. These five communication tasks included: understanding the patient's perspectives and expectations; developing rapport; presenting a comprehensive and unbiased summary of the evidence; presenting a professional recommendation in accord with best practice and the patient's preferences; and, finally, ensuring that all stakeholders understand and agree with the course of action. These results reinforce the need for health care practitioners to use clinical evidence to effectively educate their patients to facilitate shared clinical decision making. Susan Wainwright PT, MSPT University of the Sciences in Philadelphia, Philadelphia, PA
Publication Year: 2004
Publication Date: 2004-01-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 3
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