Understanding an Informed Public’s Views on the Role of Evidence in Making Health Care Decisions

Kristin L. Carman
,
Rikki Mangrum
,
Marjorie Ginsburg, Center for Healthcare Decisions
,
Shoshanna Sofaer
,
Marthe Gold, New York Academy of Medicine
,
Ela Pathak-Sen, Commotion
,
Dierdre Gilmore
,
Jennifer Richmond
,
Joanna Siegel, Patient-Centered Outcomes Research Institute

Deliberating the pros and cons of medical evidence to govern treatment decisions decreases the public’s willingness to rely solely on patient choices, especially when those choices can harm the individual or the larger community.

While people overwhelmingly believe medical evidence is key to high-quality care, they struggle with understanding what constitutes clear medical evidence—often at first equating evidence with a doctor’s accumulated experience and clinical judgment rather than clinical research results, according to the study. The public is also deeply skeptical of limiting patient choice and physician autonomy in individual cases regardless of the evidence, believing clinicians, as experts with specialized education and knowledge of the individual patient, should be free to depart from guidelines or evidence for individual situations. 

However, when given the opportunity to learn about and discuss medical evidence through a process known as public deliberation, their views can shift toward giving more weight to medical evidence and less to patient preferences, the study found. For example, when study participants learned about and discussed the threats of antibiotic resistance to individuals and the larger community when antibiotics are misused—to treat a viral infection like a cold, for instance—they were more willing to limit patient choice and physician autonomy and rely more on medical evidence.

These findings indicate that increased public understanding of evidence can play an important role in advancing evidence-based care by helping create policies that better reflect the needs and values of the public.

Access to the complete article is available on the Health Affairs website: Understanding an Informed Public’s Views on the Role of Evidence in Making Health Care Decisions.