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A New Model of Medical Decisions: Exploring the Limits of Shared Decision Making

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  • Simon N. Whitney

Abstract

This article proposes a model of medical decisions based on 2 fundamental characteristics of each decision—importance and certainty. Importance reflects a combination of objective and subjective factors; certainty is present if 1 intervention is superior and absent if 2 or more interventions are approximately equal. The proposed model uses these characteristics to predict who will have decisional priority for any given decision and shows how one class of decisions lends itself particularly well to shared decision making. Three other types of decisions are less well suited to a collaborative decision: 1) For major choices that have low certainty, patients should be encouraged to be the primary decision makers, with physician assistance as needed. 2) Most minor decisions that have high certainty are expected to be made by physicians. 3) Major decisions that have high certainty are likely to cause serious conflict when patients and physicians disagree.

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  • Simon N. Whitney, 2003. "A New Model of Medical Decisions: Exploring the Limits of Shared Decision Making," Medical Decision Making, , vol. 23(4), pages 275-280, July.
    • Handle: RePEc:sae:medema:v:23:y:2003:i:4:p:275-280
    DOI: 10.1177/0272989X03256006
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    Cited by:

    1. Mark Helfand & Lauren Saxton, 2007. "Medical Decision Making and Electronic Publishing," Medical Decision Making, , vol. 27(2), pages 98-100, March.
    2. Moss, Jennifer L. & Reiter, Paul L. & Rimer, Barbara K. & Brewer, Noel T., 2016. "Collaborative patient-provider communication and uptake of adolescent vaccines," Social Science & Medicine, Elsevier, vol. 159(C), pages 100-107.
    3. Paul K. J. Han & William M. P. Klein & Thomas C. Lehman & Holly Massett & Simon C. Lee & Andrew N. Freedman, 2009. "Laypersons' Responses to the Communication of Uncertainty Regarding Cancer Risk Estimates," Medical Decision Making, , vol. 29(3), pages 391-403, May.
    4. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    5. Scott Cantor & Robert Volk & Murray Krahn & Alvah Cass & Jawaria Gilani & Susan Weller & Stephen Spann, 2008. "Concordance of Couples’ Prostate Cancer Screening Recommendations from a Decision Analysis," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 1(1), pages 11-19, January.

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