title: Patients' knowledge about 9 common health conditions: the DECISIONS survey.
abstract: BACKGROUND
  To make informed decisions, patients must have adequate knowledge of key decision-relevant facts.
  
  
  OBJECTIVE
  To determine adults' knowledge about information relevant to common types of medication, screening, or surgery decisions they recently made.
  
  
  METHODS
  National sample of US adults identified by random-digit dialing.
  
  
  METHODS
  Cross-sectional survey conducted between November 2006 and May 2007.
  
  
  METHODS
  A total of 2575 English-speaking adults aged 40 y or older who reported having discussed the following medical decisions with a health care provider within the previous 2 y: prescription medications for hypertension, hypercholesterolemia, or depression; screening tests for colorectal, breast, or prostate cancer; or surgeries for knee/hip replacement, cataracts, or lower back pain.
  
  
  METHODS
  Participants answered knowledge questions and rated the importance of their health care provider, family/friends, and the media as sources of information.
  
  
  RESULTS
  Accuracy rates varied widely across questions and decision contexts. For example, patients considering cataract surgery were more likely to correctly estimate recovery time than those patients considering lower back pain or knee/hip replacement (78% v. 29% and 39%, P < 0.001). Similarly, participants were more knowledgeable of facts about colorectal cancer screening than those who were asked about breast or prostate cancer. Finally, respondents were consistently more knowledgeable on comparable questions about blood pressure medication than cholesterol medication or antidepressants. The impact of demographic characteristics and sources of information also varied substantially. For example, blacks had lower knowledge than whites about cancer screening decisions (odds ratio [OR] = 0.57; 95% confidence interval [CI] = 0.43, 0.75; P = 0.001) and medication (OR = 0.77; 95% CI = 0.60, 0.97; P = 0.03) even after we controlled for other demographic factors. The same was not true for surgical decisions.
  
  
  CONCLUSIONS
  The questions did not measure all knowledge relevant to informed decision making, were subject to recall biases, and may have assessed numeracy more than knowledge.
  
  
  CONCLUSIONS
  Patient knowledge of key facts relevant to recently made medical decisions is often poor and varies systematically by decision type and patient characteristics. Improving patient knowledge about risks, benefits, and characteristics of medical procedures is essential to support informed decision making.
authors.affiliation: VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. fagerlin@med.umich.edu
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
authors.forename: Karen R
authors.initials: KR
authors.lastname: Sepucha
authors.forename: Mick P
authors.initials: MP
authors.lastname: Couper
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Levin
authors.forename: Eleanor
authors.initials: E
authors.lastname: Singer
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Zikmund-Fisher
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003657:Decision Making; D055088:Early Detection of Cancer; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D013502:General Surgery; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D016017:Odds Ratio; D010353:Patient Education as Topic; D010358:Patient Participation; D055553:Prescription Drugs; D012306:Risk
chemical_list: D055553:Prescription Drugs