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How Does Feeling Informed Relate to Being Informed? The DECISIONS Survey

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  • Karen R. Sepucha
  • Angela Fagerlin
  • Mick P. Couper
  • Carrie A. Levin
  • Eleanor Singer
  • Brian J. Zikmund-Fisher

Abstract

Background An important part of delivering high-quality, patient-centered care is making sure patients are informed about decisions regarding their health care. The objective was to examine whether patients’ perceptions about how informed they were about common medical decisions are related to their ability to answer various knowledge questions. Methods A cross-sectional survey was conducted November 2006 to May 2007 of a national sample of US adults identified by random-digit dialing. Participants were 2575 English-speaking US adults aged 40 and older who had made 1 of 9 medication, cancer screening, or elective surgery decisions within the previous 2 years. Participants rated how informed they felt on a scale of 0 (not at all informed) to 10 (extremely well-informed), answered decision-specific knowledge questions, and completed standard demographic questions. Results Overall, 36% felt extremely well informed (10), 30% felt well informed (8–9), and 33% felt not at all to somewhat informed (0–7). Multivariate logistic regression analyses showed no overall relationship between knowledge scores and perceptions of being extremely well informed (odds ratio [OR] = 0.94, 95% confidence interval [CI] 0.63–1.42, P = 0.78). Three patterns emerged for decision types: a negative relationship for cancer screening decisions (OR = 0.58, CI 0.33–1.02, P = 0.06), no relationship for medication decisions (OR = 0.99, CI 0.54–1.83, P = 0.98), and a positive relationship for surgery decisions (OR = 3.07, 95% CI 0.90–10.54, P = 0.07). Trust in the doctor was associated with feeling extremely well-informed for all 3 types of decisions. Lower education and lower income were also associated with feeling extremely well informed for medication and screening decisions. Retrospective survey data are subject to recall bias, and participants may have had different perspectives or more factual knowledge closer to the time of the decision. Conclusions Patients facing common medical decisions are not able to accurately assess how well informed they are. Clinicians need to be proactive in providing adequate information to patients and testing patients’ understanding to ensure informed decisions.

Suggested Citation

  • Karen R. Sepucha & Angela Fagerlin & Mick P. Couper & Carrie A. Levin & Eleanor Singer & Brian J. Zikmund-Fisher, 2010. "How Does Feeling Informed Relate to Being Informed? The DECISIONS Survey," Medical Decision Making, , vol. 30(5_suppl), pages 77-84, September.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:5_suppl:p:77-84
    DOI: 10.1177/0272989X10379647
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    References listed on IDEAS

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    1. Brian J. Zikmund-Fisher & Mick P. Couper & Eleanor Singer & Carrie A. Levin & Floyd J. Fowler Jr. & Sonja Ziniel & Peter A. Ubel & Angela Fagerlin, 2010. "The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions," Medical Decision Making, , vol. 30(5_suppl), pages 20-34, September.
    2. Yates, J. Frank & Lee, Ju-Whei & Shinotsuka, Hiromi & Patalano, Andrea L. & Sieck, Winston R., 1998. "Cross-Cultural Variations in Probability Judgment Accuracy: Beyond General Knowledge Overconfidence?," Organizational Behavior and Human Decision Processes, Elsevier, vol. 74(2), pages 89-117, May.
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    1. Brian J. Zikmund-Fisher & Mick P. Couper & Eleanor Singer & Carrie A. Levin & Floyd J. Fowler Jr. & Sonja Ziniel & Peter A. Ubel & Angela Fagerlin, 2010. "The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions," Medical Decision Making, , vol. 30(5_suppl), pages 20-34, September.
    2. Maria Polikandrioti & John Goudevenos & Lampros K. Michalis & Ioannis G. Koutelekos & Elpida Georgiadi & Constantine Karakostas & Moses Elisaf, 2016. "Association Between Characteristics of Hospitalized Heart Failure Patients With Their Needs," Global Journal of Health Science, Canadian Center of Science and Education, vol. 8(6), pages 1-95, June.
    3. Richard M. Hoffman & Carmen L. Lewis & Michael P. Pignone & Mick P. Couper & Michael J. Barry & Joann G. Elmore & Carrie A. Levin & John Van Hoewyk & Brian J. Zikmund-Fisher, 2010. "Decision-Making Processes for Breast, Colorectal, and Prostate Cancer Screening: The DECISIONS Survey," Medical Decision Making, , vol. 30(5_suppl), pages 53-64, September.
    4. Fullard, Joshua & Sen, Sonkurt, 2022. "Tell me who you are and I will give you my consent: a light-touch intervention on consent to data linkage," ISER Working Paper Series 2022-10, Institute for Social and Economic Research.
    5. Peder A. Halvorsen, 2010. "What Information Do Patients Need to Make a Medical Decision?," Medical Decision Making, , vol. 30(5_suppl), pages 11-13, September.

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