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Comment & Response |

Actual Involvement vs Preference for Involvement as an Indicator of Shared Decision Making

René J. F. Melis, PhD1; Peter Makai, MSc1; Marieke Perry, PhD1
[+] Author Affiliations
1Department of Geriatric Medicine/Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands
JAMA Intern Med. 2014;174(4):643-644. doi:10.1001/jamainternmed.2013.12866.
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To the Editor The article by Tak and colleagues1 about the association between patient preferences for shared decision making and hospital resource use touches on a very timely topic. Many Western health care systems are preparing for the challenges of aging patients who are increasingly coping with the chronic consequences of disease rather than acute disease itself.

Central in this transition is to (re)establish a patient-physician partnership because in the many situations where “preference-sensitive” decisions2 are to be made, unwarranted practice variation is large.3 Shared decision making is expected to result in more satisfied patients who receive care better aligned with their preferences and in lower health care spending.4


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April 1, 2014
David O. Meltzer, MD, PhD; Gregory W. Ruhnke, MD, MS, MPH; Hyo Jung Tak, PhD
1Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, Illinois
2School of Public Health, University of North Texas Health Science Center, Ft Worth
JAMA Intern Med. 2014;174(4):644. doi:10.1001/jamainternmed.2013.12840.
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