Minerva

Making decisions for treating prostate cancer . . . and other stories

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4750 (Published 08 September 2016) Cite this as: BMJ 2016;354:i4750

Unshared decisions in prostate cancer

Age? Gleason score? Right, you’d better have a radical prostatectomy. Next please. It might not have been quite as crude as this, but a study of the way that urologists made decisions with 257 men with clinically localised prostate cancer in four US veterans’ hospitals showed that patients’ initial treatment preferences did not predict receipt of active treatment versus surveillance (Med Decis Making doi:10.1177/0272989X16662841). Instead, active treatment was predicted primarily by urologists’ recommendations, on the basis of medical factors alone rather than full discussion of patient important outcomes such as sexual function (mentioned in <15% of consultations).

Consent for cardiovascular procedures

Looking at consent processes for common cardiac procedures does not provide much reassurance about patient centred decision making either. A review of patient charts in one …

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