TRENDS: A National Survey of Medical Decisions


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2013 Winter Medical Editor's Meeting: Carrie Levin, PhD; Vickie Stringfellow, Bethany Gerstein

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  • Goal: to determine how decisions are made in the USGather baseline dataHow these decisions are madeWho suggested whatThe details of the interactionWhat the patients knewWhere their information came fromWhat they cared aboutHow these patterns differBy patient characteristicsBy where patients liveBy what kind of decision is being made
  • Why 40+?Because the rates of medical decisions are notably higher among those groups
  • Avg score on knowledge items correct
  • Proportion of respondents (and 95% confidence intervals) who reported discussing the pros and cons “Some” or “A lot” with their health care provider(s) for each topic
  • 4 point scale: pros. Cons, options explained, patient asked opinion
  • 42-89% of time doc recommends for a patient to have an intervention
  • Medical decisions are a pervasive part of adult life in America.
  • TRENDS: A National Survey of Medical Decisions

    1. 1. A N a t i o n a l S u r v e y o f M e d i c a l D e c i s i o n sTrendsCarrie Levin, Vickie Stringfellow, Bethany GersteinResearchJanuary 2013
    2. 2. Why did we do the study?2
    3. 3. Trends Study: Background• Conducted by IMDF/ Knowledge Networks• Address-based national Internet panel• 3,326 English speakingAmericans aged 40+• Eligible if discussed at least 1 of 10 medicaldecisions with HCP in past 2 years• Response rate of 58%• Can’t compare to DECISIONS• Oversample of 500 inWashington State3
    4. 4. Trends Study: Decisions Addressed4• Knee• Hip• Low Back• CataractsSurgery• Colorectal• Breast (women)• Prostate (men)Cancer Screening• Depression• Blood pressure• CholesterolMedication
    5. 5. Trends Study: Survey Questions5Knowledge:3-5 questions for each topicthat are the key things thatpatients need to know beforemaking a decisionGoals and Concerns:When thinking aboutwhether to haveintervention, how importantwas…Information Sources:How important wasinformation fromHCPs, media, friends orfamily, InternetDecision Process:Options, pros, cons, didprovider give recommendation,did provider ask what patientwants to doQuestions inEach Module
    6. 6. Epidemiology of Medical Decisions6In thePast2 Years:77% made at least 1 decision:52% discussed starting orstopping medication59% discussed a screening test18% discussed surgery
    7. 7. Knowledge Question: % Correct33%35%20%42%34%84%46%43%54%48%0% 20% 40% 60% 80% 100%KneeOAHip OALow BackCataractDepressionHypertensionCholesterolProstateColorectalBreast7CancerScreeningMedsSurgery
    8. 8. Discussion of Pros & Cons47%33%68%34%47%28%35%8%12%6%76%80%84%83%82%77%70%41%57%45%0% 20% 40% 60% 80% 100%KneeOAHip OALow BackCataractDepressionHypertensionCholesterolProstateColorectalBreast8CancercreeningMedsSurgeryProsCons
    9. 9. Decision Process Score2. 0.5 1.0 1.5 2.0 2.5 3.0 3.5KneeOAHip OALow BackCataractDepressionHypertensionCholesterolProstateColorectalBreast9CancerScreeningMedsSurgery
    10. 10. What do Patients Do?Have Surgery: 42%Take Medication: 79%Have Screening Test: 89%10
    11. 11. 11Thank You!