Online tools aid in shared decision-making, says doc


While a broken bone can be fixed with a cast or a ruptured appendix remedied with surgery, often decisions about treatment plans reside in a “gray zone.” That’s when doctors and patients need to be armed with the best possible statistics about the outcome of a given procedure, whether it’s for a test for prostate cancer or breast cancer.

That’s because there are pros and cons associated with these types of decisions, writes Dhruv Khullar, M.D., a resident physician at Massachusetts General Hospital and Harvard Medical School, in The New York Times.

“This is partly because while many doctors tend to think in stats, most people think in stories. Salient or visceral experiences, like ‘my neighbor had a stroke’ or vomiting blood into a toilet, are immediately accessible. Abstract risks, like the ones I presented to my patient, can be difficult to grasp,” he writes, describing his conversation with a patient about how a blood thinner wouild lower his risk of having a stroke but increase his risk of bleeding.

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When a patient with cancer is weighing their options, they need to be mindful about whether they want to endure a six-month round of chemotherapy and uncontrollable nausea or three chemotherapy-free months at home with their family, for example.

These are not easy decisions to make, but Khullar supports the use of online interactive tools that allow patients to input their personal health characteristics and learn by means of visually compelling charts and graphs what their potential outcomes could be, alongside their doctor.

He points to a Cochrane review of more than 100 studies and 34,000 patients illustrating that, with a tangible understanding of their options, patients can make smarter decisions about the right treatment paths.

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