Current News

Michael J. Barry, MD

Current news from the Informed Medical Decisions Foundation.

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Michael J. Barry, MD

The President’s Corner: July/August 2015

In a 2012 report for The King’s Fund, Foundation cofounder Al Mulley and colleagues described the problem of misdiagnosis of patients’ preferences. “Preference misdiagnosis” may be the most common form of medical error in health care. It can occur when a person has more than one medically reasonable course of action open to him or her. A clinician, sometimes supported by recommendations from clinical practice guidelines, may prescribe or withhold a treatment based on what the evidence best supports and what he or she thinks the patient would want. However, research shows that among fully informed patients who understand a certain treatment’s possible benefits and risks, some would want that prescribed treatment, and some would not want that treatment prescribed. While there is evidence that preference misdiagnosis occurs, its epidemiology and solutions have not been well described. Continue reading

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Jack Fowler

Three Elements for Better Studies Evaluating the Effects of Decision Aids

The study designs needed to collect this data vary, and no one study is going to collect data addressing all of these important evaluative questions. However, we very much need more quality data on when and how using DAs affects patient care, and we should try to take advantage of every opportunity to collect good evaluation data when DAs are introduced into a new setting. There are three elements to think about when considering the collection of evaluation data. Continue reading

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Jack Fowler

Do the Decision Aids Lead to Better Decisions?

How would we know a “better” decision if we saw one? Donald Berwick, former director of the Centers for Medicare and Medicaid Services, proposed what he called the “Triple Aim”: better health care and better health at lower cost. One way to answer the question of whether the decisions are “better”—and thereby demonstrate the “value” of using DAs and other patient support materials—is to collect data to evaluate how each of these aims is affected. Continue reading

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Jack Fowler

How is Decision Making Affected by Decision Aid Exposure?

The next key evaluative question is this: How was decision making affected by exposure? There are a number of reasons to introduce accurate, complete, understandable information to patients. And a comprehensive assessment of how well those objectives are achieved requires appropriate data collection procedures and measurement. Continue reading

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Michael J. Barry, MD

The President’s Corner: May/June 2015

Together, Jack and Al wrestled with how to find the “right rate” of medical care, preserving wanted variation attributable to patients’ clinical conditions and preferences while reducing unwanted variation due to clinicians’ preferences. They concluded that the answer would be found in ensuring that patients are fully informed about and involved in their medical decisions. This melding of minds produced the Informed Medical Decisions Foundation in 1989. And for 26 years we’ve had truly big shoes to fill in carrying forward their ideals! Continue reading

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