title: Understanding An Informed Public's Views On The Role Of Evidence In Making Health Care Decisions.
abstract: Policy makers and practitioners increasingly believe that medical evidence plays a critical role in improving care and health outcomes and lowering costs. However, public understanding of the role of evidence-based care may be different. Public deliberation is a process that convenes diverse citizens and has them learn about and consider ethical or values-based dilemmas and weigh alternative views. The Community Forum Deliberative Methods Demonstration project, sponsored by the Agency for Healthcare Research and Quality, obtained informed public views on the role of evidence in health care decisions through seventy-six deliberative groups involving 907 people overall, in the period August-November 2012. Although participants perceived evidence as being essential to high-quality care, they also believed that personal choice or clinical judgment could trump evidence. They viewed doctors as central figures in discussing evidence with patients and key arbiters of whether to follow evidence in individual cases. They found evidence of harm to individuals or the community to be more compelling than evidence of effectiveness. These findings indicate that increased public understanding of evidence can play an important role in advancing evidence-based care by helping create policies that better reflect the needs and values of the public.
authors.affiliation: Kristin L. Carman (kcarman@air.org) is vice president of the Health and Social Development Program at the American Institutes for Research (AIR) in Washington, D.C.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Carman
authors.affiliation: Maureen Maurer is a principal researcher in the Health and Social Development Program at AIR in Chapel Hill, North Carolina.
authors.forename: Maureen
authors.initials: M
authors.lastname: Maurer
authors.affiliation: Rikki Mangrum is a researcher in the Health and Social Development Program at AIR in Chapel Hill.
authors.forename: Rikki
authors.initials: R
authors.lastname: Mangrum
authors.affiliation: Manshu Yang is a senior researcher in the Health and Social Development Program at AIR in Chapel Hill.
authors.forename: Manshu
authors.initials: M
authors.lastname: Yang
authors.affiliation: Marjorie Ginsburg is executive director of the Center for Healthcare Decisions, in Sacramento, California.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Ginsburg
authors.affiliation: Shoshanna Sofaer is director of strategic research planning in the Health and Social Development Program at AIR in New York City.
authors.forename: Shoshanna
authors.initials: S
authors.lastname: Sofaer
authors.affiliation: Marthe R. Gold is a senior scholar at the New York Academy of Medicine, in New York City.
authors.forename: Marthe R
authors.initials: MR
authors.lastname: Gold
authors.affiliation: Ela Pathak-Sen is director and co-owner of Commotion, a company that specializes in patient and public involvement in health care, in Gloucester, the United Kingdom.
authors.forename: Ela
authors.initials: E
authors.lastname: Pathak-Sen
authors.affiliation: Dierdre Gilmore is a senior researcher in the Health and Social Development Program at AIR in San Mateo, California.
authors.forename: Dierdre
authors.initials: D
authors.lastname: Gilmore
authors.affiliation: Jennifer Richmond is a research associate in the Health and Social Development Program at AIR in Chapel Hill.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Richmond
authors.affiliation: Joanna Siegel is program director for dissemination and implementation at the Patient-Centered Outcomes Research Institute, in Washington, D.C.
authors.forename: Joanna
authors.initials: J
authors.lastname: Siegel
mesh_terms: D000328:Adult; D000368:Aged; D003256:Community Participation / Q000706:statistics & numerical data*; D032882:Comprehension; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D019317:Evidence-Based Medicine / Q000941:ethics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D036301:Qualitative Research; D012380:Role; D011795:Surveys and Questionnaires; D014481:United States
keywords: Consumer Issues; Ethical Issues; Evidence-Based Medicine; Legal/Regulatory Issues; Public Opinion