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5 Apr 2016
Journal Article

Understanding an Informed Public’s Views on the Role of Evidence in Making Health Care Decisions

Kristin L. Carman, Maureen Maurer, Rikki Mangrum, and Manshu Yang, AIR
Marjorie Ginsburg, Center for Healthcare Decisions
Shoshanna Sofaer, AIR
Marthe Gold, New York Academy of Medicine
Ela Pathak-Sen, Commotion
Dierdre Gilmore and Jennifer Richmond, AIR
Joanna Siegel, Patient-Centered Outcomes Research Institute

Deliberating the pros and cons of medical evidence to govern treatment decisions decreases the public’s willingness to rely solely on patient choices, especially when those choices can harm the individual or the larger community.

While people overwhelmingly believe medical evidence is key to high-quality care, they struggle with understanding what constitutes clear medical evidence—often at first equating evidence with a doctor’s accumulated experience and clinical judgment rather than clinical research results, according to the study. The public is also deeply skeptical of limiting patient choice and physician autonomy in individual cases regardless of the evidence, believing clinicians, as experts with specialized education and knowledge of the individual patient, should be free to depart from guidelines or evidence for individual situations. 

However, when given the opportunity to learn about and discuss medical evidence through a process known as public deliberation, their views can shift toward giving more weight to medical evidence and less to patient preferences, the study found. For example, when study participants learned about and discussed the threats of antibiotic resistance to individuals and the larger community when antibiotics are misused—to treat a viral infection like a cold, for instance—they were more willing to limit patient choice and physician autonomy and rely more on medical evidence.

These findings indicate that increased public understanding of evidence can play an important role in advancing evidence-based care by helping create policies that better reflect the needs and values of the public.

Access to the complete article is available on the Health Affairs website: Understanding an Informed Public’s Views on the Role of Evidence in Making Health Care Decisions.

Related Projects

Project

Community Forum Deliberative Methods Demonstration

Growing evidence indicates that informing and engaging the public—both as patients and as citizens—can help achieve better care, better health, and lower costs. AIR research, conducted as part of the Agency for Healthcare Research and Quality Deliberative Methods Demonstration, found that public deliberation is an effective way to gather informed public views on complex health policy issues, such as the role of medical evidence in treatment decisions.

Related Work

15 May 2015
Journal Article

Effectiveness of Public Deliberation Methods for Gathering Input on Issues in Healthcare: Results from a Randomized Trial

The U.S. health care system’s complexity, coupled with the emotional and personal nature of serious illness or injury, often makes it difficult for policymakers to obtain informed public views to help guide decisions on complicated health care issues. This study found that public deliberation, which encourages people to become informed about a topic and consider alternative perspectives, shifted participants' attitudes about the importance of medical evidence in treatment decisions.
Topic: 
Health, Patient, Family, and Stakeholder Engagement

Further Reading

  • Effectiveness of Public Deliberation Methods for Gathering Input on Issues in Healthcare: Results from a Randomized Trial
  • Community Forum Deliberative Methods Demonstration
  • AIR Experts to Give Presentations on Health-Related Research During the Annual AcademyHealth Conference
  • Study Finds ‘Public Deliberation’ Effectively Captures Informed Views on Complex Health Policy Issues
  • Public Deliberation: Bringing Common Sense to Complex Health Policy Issues
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Topic

Health
Patient, Family, and Stakeholder Engagement

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