Journal
JOURNAL OF HEALTH PSYCHOLOGY
Volume 9, Issue 1, Pages 29-40Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1359105304036100
Keywords
definition of disease; quality of life; shared medical decision making; uncertainty
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Funding
- AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [R01HS009170] Funding Source: NIH RePORTER
- AHRQ HHS [R01-HS09170] Funding Source: Medline
- ODCDC CDC HHS [UC57/CCU920678-02] Funding Source: Medline
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The practice of medicine links diagnosis to treatment. However, for many diagnosed conditions diagnosis and treatment may not affect health outcome. Examples include low-grade cancers that do not influence life expectancy or quality of life. Further, there is considerable uncertainty about the point along a biologic continuum where treatment should begin. Changes in diagnostic thresholds often increase healthcare costs even though the benefit of the treatment is uncertain. Although this uncertainty is understood by the healthcare providers, it often is not shared patients. We advocate a new paradigm called shared medical decision making that makes uncertainty about diagnosis and treatment transparent to patients and engages them in the treatment decision process.
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