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Too Much Information in Medical Decision Making?

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Conversation Continues feature ongoing discussions or news on current health topics with links to related materials.'  They are part of the Center for Advancing Health's portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it. Written by Sarah Jorgenson.



Paula Span of The New York Times New Old Age blog could have used more information about medical risks when helping her father decide whether to remove a benign mole. Span wanted to know what the odds were of a benign mole turning malignant. When presented with careless statistical information from the physician, she asks, 'How can anyone make a rational decision without better information than that?' Span and her father decided to leave the mole since he was 89 years-old and the threat seemed non-urgent.

In a recent post, Jessie Gruman, asked, 'Should Doctors Protect Us from Data about Medical Risks?' Jessie challenges physician and ethicist Peter Schwartz's Hastings Center paper advocating that clinicians should assess each individual and determine whether numerical data should be presented to each person, saying:
'To argue that our clinicians should selectively protect some of us from empirical risk information is a wasteful distraction from the larger challenges we face in getting the most out of our health care as part of our effort to live for as well and as long as we can.'

Continuing this dialog, researcher Naomi Freundlich of Health Beat says, 'In Shared Decision Making There Can Never Be 'Too Much Information.'' She expands Gruman's argument providing evidence of how a decision aid may help the person with high LDL cholesterol mentioned in Gruman's post. Freundlich also recognizes, 'That this is far from an academic argument.' She cites The Affordable Care Act and how it is establishing standards and a certification process for education tools highlighting groups like Dartmouth's Center for Shared Decision Making and the Foundation for Medical Decision Making and citing randomized control trials that studied the impact of these decision making tools. Freundlich agrees with physician and behavioral scientist Peter Ubel who has an accompanying commentary on Schwartz's piece. He says:
'The ethics of autonomy and informed consent are a moving target because behavioral scientists continue to find new ways to improve decision-making. We should not take people's cognitive limitations as a fait accompli. Instead, we should experiment with ways of overcoming them.'

So what do you think, can we have too much information?

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Conversation Continues feature ongoing discussions or news on current health topics with links to related materials.  They are part of the Center for Advancing Health’s portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.


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How Much Information Should Patients Get? | Peter Ubel says
July 25, 2011 at 9:54 AM

[...] much information patients should get when facing important medical decisions.  You might want to click on this link and join [...]