Patient-specific Qualitative Data Made Understandable

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The Statin Choice Tool

The Statin Choice Tool was developed as part of the The Wiser Choices Program,¹ which was itself created at the Montori Lab of the Mayo Clinic.

The Wiser Choices Program is described in this excerpt from the Mayo web site:

These decision aids present evidence-based estimates, specific to a given patient, of the potential benefits and disadvantages of the available treatment options in straightforward language augmented with graphical representation of statistical findings (see image atop this post). The interlinked goals are to involve the patient in the decision-making process in a meaningful way, improve the acceptability of the treatment decision to the patient, enhance adherence, and improve the clinical outcome.

Commentary

Making decisions about treatment is a difficult process, even if one buys into the premise that such decisions should be based on research-based evidence.

Healthcare professionals themselves often misinterpret statistical findings; a patient who lacks training in statistics, research, and the pathology and treatment of his or her disorder can hardly be expected to be immediately capable of making a choice in his or her own best interest. Educating such a patient can be an arduous, time-consuming task for the patient and clinician, especially since the effort must be accomplished when the patient is under stress.

Complicating the situation is the concern that the clinician will exert undue influence on the patient, rendering the patient’s role in that decision a sham. Some bioethicists would hold that a physician should lay out the patient’s treatment options with each choice’s risks and benefits, carefully abstaining from any indication of a preference for one or another, even if the patient requests that information. Others contend that such a mechanical process belies the human relationship between patient and clinician and robs the patient of the professional’s expertise.

The Wiser Choice Program and its Statin Choice Tool are attempts to efficaciously convey essential information about treatment to the patient in such a way that the patient’s role in determining treatment is legitimate and meaningful.

Tomorrow’s post will focus on a recently published study designed to determine if the Statin Choice Tool accomplishes that goal.

Update: Statin Choice Tool Clinical Trial

Footnotes

1. Further information about the Wiser Choices Program, including this documentation:
   * Statin Choice Instruction Manual for Providers
   * Statin Choice Decision Aid Informational Booklet for Patients
   * Case 1 – High-Risk
   * Case 2 – Mid-Risk
   * Case 3 – Low-Risk
   * Pen-and-paper coronary risk estimator based on the UKPDS

   can be found at mayoresearch.mayo.edu/…/decision-aids.cfm [back]

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