Last week, the American Board of Internal Medicine (ABIM) Foundation launched their Choosing Wisely® initiative. The nine medical societies in support of the initiative are warning patients and doctors to choose wisely when it comes to 45 common medical tests. Dr. Michael J. Barry, president of the Informed Medical Decisions Foundation, provides a brief overview of the initiative and some key takeaways in the short video below.
Prostate cancer screening and treatment made the news again this week with Warren Buffett’s announcement that he has early stage, localized, prostate cancer identified through the use of a PSA screening test. The 81 year-old Buffett is six years older than the recommended cut off age for regular PSA testing. He has opted for two months of radiation to treat the cancer. Both Buffett’s diagnosis and treatment choice has put the spotlight on a diagnostic tool and disease that is poorly understood by many people.
This article describes a study that found that patients with cancer who viewed a video of various goals-of-care options, in addition to a verbal description were more likely to prefer comfort measures and avoid CPR. The study found that these patients were also more knowledgeable regarding advanced care treatment options and felt more certain about their decision compared to patients only hearing a verbal narrative. This article differs from some other studies regarding decision aids since other uses of video decision support tools have focused on helping people make treatment or screening decisions, whereas this video was used to initiate end-of-life discussions.
This is the most comprehensive review article that examines evidence of patient decision aids from numerous randomized control trials and provides a strong evidence base for the positive benefits of patient decision aids. The review finds that when patients use decision aids they: a) improve their knowledge of the options b) have more accurate expectations of possible benefits and harms c) reach choices that are more consistent with their informed values and d) participate more in decision making.