September 26, 2012
I have talked often about the importance of evidence to guide our informed decisions about health. A new paper from the Institute of Medicine discusses how to talk about medical evidence [see http://www.iom.edu/Global/Perspectives/2012/~/media/Files/Perspectives-Files/2012/Discussion-Papers/VSRT-Evidence.pdf].
One of the interesting issues considered addresses ways that language relates to patient confidence about evidence and health care. 1,068 US adults were surveyed to answer this question: 71% were White, 48% male, 46% 55 years of age and older, 55% rated themselves as in ‘very good’ or ‘excellent’ health, 62% were not living with any chronic condition, 88% had health insurance, and 36% usually or always bring a list of questions with them to ask their doctors.
The summary of findings is in Table 1. ‘What is proven to work best’ was found to be the phrase leading to the greatest level of confidence, 79%–in the evidence used for their health care.
I wonder, given that so many come prepared to ask questions, if the participants would ask any questions about the evidence. Things like ‘is the evidence based on someone my age, my biological sex, or my race/ethcnity?’
I wonder, too, about the levels of education for this group. IOM has convened panels to write reports about health illiteracy in this nation. What does ‘evidence’ mean to the large percentage of adults in the US who are health illiterate? What does ‘evidence’ mean to this group of mostly white, mostly insured, and very healthy personal advocates [they ask a lot of questions on their own behalf] participants?
Hopefully, the responses do not become scripts for medical interview education.
The paper also makes ‘evident’ that US health consumers want their personal goals to take a priority in conversations about their health with health professionals. So, we need to understand what goals the patient has about the ‘evidence’ being used to guide decisions. Is it their goal to understand more about what makes up medical evidence? If so, I am not ‘confident’ that this advances that aim.
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