Patient preferences in surgical decisions

Surgical decision making: Challenging dogma and incorporating patient preferences is an opinion piece published last month in Journal of the American Medical Association.  Author Karan Chhabra and his colleagues discuss three recent trials where common surgical procedures (appendectomy, colectomy and knee replacement) were compared to less aggressive or non-operative alternatives.

In all cases, the less aggressive treatments were not definitively better than the operative alternatives, but they were safe and had comparative outcomes.  In these situations a shared decision-model with patients should be encouraged.  Although this is challenging, "physicians should create a culture in which patients’ values determine the treatment outcomes that matter most. After all, patients are the ones who must live with the consequences."

Chhabra KR, Sacks GD, Dimick JB. JAMA. 2017;317(4):357-8.  http://dx.doi.org/10.1001/jama.2016.18719. (Available via CIAP or contact your health librarian)