Nav: Home

Focus on treatment decisions: Doctor and patient should decide together

October 23, 2015

Doctor and patient decide together which treatment to perform--this ideal is now anchored in the Law on Patient Rights and the Professional Code for Physicians in Germany. Shared decision making, in which doctor and patient exchange knowledge concerning the patient's disease and its treatments, discuss treatment options, and jointly choose one, is the gold standard. This edition of Deutsches Ärzteblatt International, which focuses on patient involvement, contains two original articles investigating the following questions: Do patients benefit from shared decision making? Is treatment more effective as a result? How do physicians gain from training in shared decision making?

In their systematic review, Katarina Hauser et al. (Dtsch Arztebl Int 2015; 112: 665-71) investigate studies in which some patients took part in shared decision making, while the treatment decisions of others were made in the conventional way. They used disease-relevant endpoints in order to compare the efficacy of treatment in the two patient groups. Treatment outcomes were found to improve after shared decision making in just under half of the studies. However, the authors state that they were unable to reach a definite conclusion regarding shared decision making because it was only possible to evaluate a small number of papers: just 22 studies met the inclusion criteria.

Martin Härter et al. (Dtsch Arztebl Int 2015; 112: 672-9) conducted a randomized controlled trial to analyze whether physicians were better prepared for consultations on treatment decisions with their cancer patients after 12 hours of training in shared decision making, and whether the patients benefited as a result. Patients were interviewed immediately before and three months after their doctor-patient consultations, using a questionnaire which included questions concerning their confidence in and satisfaction with their treatment decisions. This revealed that patients of physicians who had been trained in shared decision making were no more confident in their decisions than those of physicians who had not. However, after training, the physicians' shared decision-making skills were better, and their patients had slightly lower scores for anxiety and depression. The authors point out that physicians participating in shared decision making training programs have many hurdles to overcome and therefore only 23 of the 900 originally contacted physicians completed the whole trial. They call for the promotion and funding of studies on shared decision-making training and evaluation.

Deutsches Aerzteblatt International

Related Decisions Articles:

How neurons use crowdsourcing to make decisions
When many individual neurons collect data, how do they reach a unanimous decision?
Diverse populations make rational collective decisions
Yes/no binary decisions by individual ants can lead to a rational decision as a collective when the individuals have differing preferences to the subject, according to research recently published in the journal Royal Society Open Science.
Understanding decisions: The power of combining psychology and economics
A new paper published in the Proceedings of the National Academy of Sciences shows how collaborations between psychologists and economists lead to better understanding of such decisions than either discipline can on its own.
Trading changes how brain processes selling decisions
Experience in trading changes how the human brain evaluates the sale of goods, muting an economic bias known as the endowment effect in which people demand a higher price to sell a good than they're willing to pay for it.
Modelling how the brain makes complex decisions
Researchers have built the first biologically realistic mathematical model of how the brain plans and learns when faced with a complex decision-making process.
Focus on treatment decisions: Doctor and patient should decide together
This edition of Deutsches Ärzteblatt International, which focuses on patient involvement, contains two original articles investigating the following questions: do patients benefit from shared decision making?
Surprise: Your visual cortex is making decisions
The part of the brain responsible for seeing is more powerful than previously believed.
Guam research reveals complications of conservation decisions
A Guam native insect impacts a native tree, posing a conundrum for conservationists.
Researchers determine how groups make decisions
Researchers from Carnegie Mellon University have developed a model that explains how groups make collective decisions when no single member of the group has access to all possible information or the ability to make and communicate a final decision.
Physicians should help families with decisions about end-of-life care
About 20 percent of Americans spend time in an intensive care unit around the time of their death, and most deaths follow a decision to limit life-sustaining therapies.

Related Decisions Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".