Understanding An Informed Public’s Views On The Role Of Evidence In Making Health Care Decisions

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VOL. 35| NO. 4April 2016Patients’ & Consumers’ Use Of Evidence

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Understanding An Informed Public’s Views On The Role Of Evidence In Making Health Care Decisions

1. Kristin L. Carman1,*, 
2. Maureen Maurer2, 
3. Rikki Mangrum3, 
4. Manshu Yang4,
5. Marjorie Ginsburg5, 
6. Shoshanna Sofaer6, 
7. Marthe R. Gold7, 
8. Ela Pathak-Sen8,
9. Dierdre Gilmore9, 
10. Jennifer Richmond10 and 
11. Joanna Siegel11

+Author Affiliations

1. ¹Kristin L. Carman (kcarman@air.org) is vice president of the Health and Social Development Program at the American Institutes for Research (AIR) in Washington, D.C.
2. ²Maureen Maurer is a principal researcher in the Health and Social Development Program at AIR in Chapel Hill, North Carolina.
3. ³Rikki Mangrum is a researcher in the Health and Social Development Program at AIR in Chapel Hill.
4. ⁴Manshu Yang is a senior researcher in the Health and Social Development Program at AIR in Chapel Hill.
5. ⁵Marjorie Ginsburg is executive director of the Center for Healthcare Decisions, in Sacramento, California.
6. ⁶Shoshanna Sofaer is director of strategic research planning in the Health and Social Development Program at AIR in New York City.
7. ⁷Marthe R. Gold is a senior scholar at the New York Academy of Medicine, in New York City.
8. ⁸Ela Pathak-Sen is director and co-owner of Commotion, a company that specializes in patient and public involvement in health care, in Gloucester, the United Kingdom.
9. ⁹Dierdre Gilmore is a senior researcher in the Health and Social Development Program at AIR in San Mateo, California.
10. ¹⁰Jennifer Richmond is a research associate in the Health and Social Development Program at AIR in Chapel Hill.
11. ¹¹Joanna Siegel is program director for dissemination and implementation at the Patient-Centered Outcomes Research Institute, in Washington, D.C.

1. ↵*Corresponding author

Abstract

Policy makers and practitioners increasingly believe that medical evidence plays a critical role in improving care and health outcomes and lowering costs. However, public understanding of the role of evidence-based care may be different. Public deliberation is a process that convenes diverse citizens and has them learn about and consider ethical or values-based dilemmas and weigh alternative views. The Community Forum Deliberative Methods Demonstration project, sponsored by the Agency for Healthcare Research and Quality, obtained informed public views on the role of evidence in health care decisions through seventy-six deliberative groups involving 907 people overall, in the period August–November 2012. Although participants perceived evidence as being essential to high-quality care, they also believed that personal choice or clinical judgment could trump evidence. They viewed doctors as central figures in discussing evidence with patients and key arbiters of whether to follow evidence in individual cases. They found evidence of harm to individuals or the community to be more compelling than evidence of effectiveness. 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.

• Consumer Issues
 
• Ethical Issues
 
• Evidence-Based Medicine
 
• Public Opinion
• Legal/Regulatory Issues