Evidence-based Medicine On the Same Page™

The EBM Information Quest: Is it true? Is it useful? Is it usable?™

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About PMID Numbers:
We frequently utilize a PMID number in place of a citation. Where PMID numbers are available, enter that number into the PubMed search box to retrieve that citation and listing.

 

Evidence-based Information & Decision Aid Examples for Health Care Professionals & Patients—Putting Everyone on the Same Page

Patient-centered Resources: General

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Use of our website implies agreement to our Notices. Citations for references available upon request.

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Important
Not all clinical recommendations from other sources have been reviewed for validity and ours may or may not be uptodate, so selections below should be viewed as representing examples of approaches and formats for communications, etc. Feel free to contact us for details. Read our Health Care Information Source Cautions at Notices.

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Contents

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What matters to Patients?
Here's what we think — click here.

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DelfiniApproach to Patient Decision-making  
Studies show that physicians tend to describe decisions to patients, but tend to exclude describing benefits, harms, risks, costs, uncertainties and alternatives. Patient-centered care is about choice. Physicians need to be prepared to discuss all these areas with patients.

Studies also show that patients have individual preferences for decision styles depending upon their unique circumstances. These styles are autonomous, physician-directed and shared. Autonomous decision-making is performed solely by the patient. Physician-directed means the physician chooses. Shared decision-making is jointly performed by physicians and patients. Patient-centered care involves the patient in deciding which decision style to use, based on that patient's own needs, values and preferences.

Physicians may wish to favor a more prescriptive style where the evidence is strong. Shared-decision making is often most optimal where there are uncertainties and/or equally reasonable alternatives.

Patient choice is at the heart of patient-centered care: Patient Decision-making Model

How you communicate the differences in treatment choices in patients hugely matters. Studies show an acceptance rate of 88% to 31%! Click here to learn more about estimates of effect.

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Recommended Reading

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Physician-Patient Communications (see also Delfini "Patient Encounter Map" for Information & Engagement)

Beck RS, Daughtridge R, Sloane PD.
Physician-Patient Communication in the Primary Care Office: A Systematic Review.
JABFP 2002. 15:25-38. The Journal of the American Board of Family Practice. PMID: 11841136. Abstract. Delfini commentary here.

Hall JA; Roter DL; Katz NR.
Meta-analysis of correlates of provider behavior in medical encounters.
Medical Care;1988, 26:657-675. PMID: 3292851. Abstract.

Stewart MA.
Effective Physician-Patient Communication and Health Outcomes: A Review
CMAJ 1995.152:1423-1433. PMID: 7728691. Abstract. Delfini commentary here.

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Decision-making

Epstein RM, Alper BS, Quill TE.
Communicating evidence for participatory decision making.
JAMA. 2004 May 19;291(19):2359-66. Review. PMID: 15150208. Abstract.

Say R, Thomson R.
The importance of patient preferences in treatment decisions — challenges for doctors.

BMJ. 2003 Sep 6;327(7414):542-5 Full text. Delfini commentary here.

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Conveying Risk (see also Delfini Rx Messaging Scriptshere )

Gigerenzer G, Edwards A.
Simple tools for understanding risks: from innumeracy to insight.
BMJ. 2003 Sep 27;327(7417):741-4.
PMID: 14512488. Full text.

Paling J.
Strategies to help patients understand risks.
BMJ. 2003 Sep 27;327(7417):745-8. PMID: 14512489. Full text.

O'Connor AM, Legare F, Stacey D.
Risk communication in practice: the contribution of decision aids.
BMJ. 2003 Sep 27;327(7417):736-40. PMID: 14512487. Full text.

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Adherence

McDonald HP, Garg AX, Haynes RB.
Interventions to enhance patient adherence to medication prescriptions: scientific review.
Health Research Methodology Program, McMaster University School of Graduate Studies, Hamilton, Ontario, Canada. JAMA 2002 Dec 11;288(22):2868-79 PMID: 15139471. Abstract. Delfini commentary here.

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