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Comment & Response |

Patient-Physician Shared Decision Making—Reply

Steven J. Katz, MD, MPH1; Sarah Hawley, PhD1
[+] Author Affiliations
1Department of Medicine, University of Michigan, Ann Arbor
JAMA. 2014;311(8):864. doi:10.1001/jama.2013.285166.
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In Reply Similar to Mr Veroff and colleagues, we are strong proponents of shared decision making between clinicians and their patients, including incorporating values and preferences into treatment decisions. We lead a research program funded by the National Cancer Institute to address better ways to do this, including developing and evaluating new patient-centered deliberation tools.1

However, in our Viewpoint we concluded that the literature does not support the role of shared decision making in reducing overtreatment and medical cost inflation. We established that there were important flaws in a frequently cited Cochrane meta-analysis that suggested that patient decision aids were associated with less extensive surgical treatment. The letter from Veroff and colleagues further highlights the challenges of disentangling patient vs clinician influences on utilization in studies assessing the effect of shared decision making on cost and treatment patterns.

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February 26, 2014
David R. Veroff, MPP; John D. Birkmeyer, MD; David E. Wennberg, MD, MPH
1Health Dialog, Boston, Massachusetts
2University of Michigan Health System, Ann Arbor
3Northern New England Accountable Care Collaborative, Portland, Maine
JAMA. 2014;311(8):863. doi:10.1001/jama.2013.285157.
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