New decision making aids should help patients make the decisions

Primary care pp 490, 493

Many medical decisions fall into a grey area where the optimal choice for an individual patient may be unclear and where reasonable people might choose differently. Common examples include elective surgical procedures, such as lumbar discectomy or resection for benign prostatic hypertrophy. Drug treatment may pose similar choices when treatment offers both appreciable benefits and appreciable risks. Hormone replacement therapy in postmenopausal women is an example, as is anticoagulant therapy in patients with non-valvular atrial fibrillation. Decisions about such treatments are made daily in clinical practice, and there is considerable evidence that patients want more information and greater involvement in them. In general we do a poor job of providing information, though this week's BMJ includes studies of two examples of a new generation of interactive methods of patient information that holds promise of improvement. 1 2