Intended for healthcare professionals


Communicating risk to patients in the emergency department

BMJ 2016; 355 doi: (Published 05 December 2016) Cite this as: BMJ 2016;355:i6437
  1. Anne M Stiggelbout, professor1,
  2. J Wouter Jukema, professor2,
  3. Ellen E Engelhardt, postdoctoral researcher3,
  4. Carla van den Bos, patient advocate4,
  5. Arwen H Pieterse, associate professor1
  1. 1Department of Medical Decision Making, Leiden University Medical Centre, Leiden, Netherlands
  2. 2Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands
  3. 3Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, Netherlands
  4. 4Patient Advisory Board, Leiden University Medical Centre, Leiden, Netherlands
  1. Correspondence to: A M Stiggelbout a.m.stiggelbout{at}

Shared decision making works well even in this highly charged setting

“Nothing about me without me”1 and “Really putting patients at the centre of healthcare”2 are just two expressions of the call for patient involvement and shared decision making. For many, shared decision making is becoming the norm, at least in preference sensitive decisions, but for others it is seen as just a fashionable phrase, to be followed by business as usual. Indeed, sharing decisions seems to occur to a fairly limited extent in daily practice.3 In a linked report of a noteworthy study involving patients at all stages from study design to publication, Hess and colleagues took up the challenge of supporting patient decision making in the emergency department (doi:10.1136/bmj.i6165).4 They show that even in this setting patients can be involved. With the implementation of a “quantitative pretest probability webtool” built into a decision aid for the clinical encounter, the authors more than doubled patient …

View Full Text

Log in

Log in through your institution


* For online subscription