Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020

by Gerd Gigerenzer (Editor), J.A. Muir Gray (Editor)

Overview

How eliminating “risk illiteracy” among doctors and patients will lead to better health care decision making.

Contrary to popular opinion, one of the main problems in providing uniformly excellent health care is not lack of money but lack of knowledge—on the part of both doctors and patients. The studies in this book show that many doctors and most patients do not understand the available medical evidence. Both patients and doctors are “risk illiterate”—frequently unable to tell the difference between actual risk and relative risk. Further, unwarranted disparity in treatment decisions is the rule rather than the exception in the United States and Europe. All of this contributes to much wasted spending in health care.

The contributors to Better Doctors, Better Patients, Better Decisions investigate the roots of the problem, from the emphasis in medical research on technology and blockbuster drugs to the lack of education for both doctors and patients. They call for a new, more enlightened health care, with better medical education, journals that report study outcomes completely and transparently, and patients in control of their personal medical records, not afraid of statistics but able to use them to make informed decisions about their treatments.

Product Details

ISBN-13:	9780262518529
Publisher:	MIT Press
Publication date:	01/11/2013
Series:	Strüngmann Forum Reports , #6
Pages:	416
Product dimensions:	8.70(w) x 5.70(h) x 1.00(d)
Age Range:	18 Years

About the Author

Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin. He is the author of Calculated Risks, among other books, and the coeditor of Bounded Rationality: The Adaptive Toolbox and Heuristics and the Law, both published by the MIT Press.

J. A. Muir Gray is director of the National Knowledge Service, Oxford. He is the author of Evidence-Based Healthcare.

Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin. He is the author of Calculated Risks, among other books, and the coeditor of Bounded Rationality: The Adaptive Toolbox and Heuristics and the Law, both published by the MIT Press.

J. A. Muir Gray is director of the National Knowledge Service, Oxford. He is the author of Evidence-Based Healthcare.

Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin. He is the author of Calculated Risks, among other books, and the coeditor of Bounded Rationality: The Adaptive Toolbox and Heuristics and the Law, both published by the MIT Press.

J. A. Muir Gray is director of the National Knowledge Service, Oxford. He is the author of Evidence-Based Healthcare.

Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin. He is the author of Calculated Risks, among other books, and the coeditor of Bounded Rationality: The Adaptive Toolbox and Heuristics and the Law, both published by the MIT Press.

J. A. Muir Gray is director of the National Knowledge Service, Oxford. He is the author of Evidence-Based Healthcare.

Jay Schulkin is Research Professor in the Department of Neuroscience at Georgetown University, where he is also a member of the Center for the Brain Basis of Cognition.

Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin. He is the author of Calculated Risks, among other books, and the coeditor of Bounded Rationality: The Adaptive Toolbox and Heuristics and the Law, both published by the MIT Press.

Ralph Hertwig is Director of the Center for Adaptive Rationality at the Max Planck Institute for Human Development in Berlin.

Table of Contents

The Ernst Strüngmann Forum vii

List of Contributors ix

Health Literacy: Is the Patient the Problem?

1 Launching the Century of the Patient Gerd Gigerenzer J. A. Muir Gray 3

2 When Misinformed Patients Try to Make Informed Health Decisions Wolfgang Gaissmaier Gerd Gigerenzer 29

3 Reducing Unwarranted Variation in Clinical Practice by Supporting Clinicians and Patients in Decision Making Albert G. Mulley John E. Wennberg 45

4 Do Patients Want Shared Decision Making and How Is This Measured? Martin Härter Daniela Simon 53

Health Illiteracy: Roots in Research

5 Health Research Agendas and Funding David E. Nelson 61

6 Reporting of Research: Are We in for Better Health Care by 2020? Holger Schünemann Davina Ghersi Julia Kreis Gerd Antes Jean Bousquet 83

7 Medical Journals Can Be Less Biased J. A. Muir Gray 103

8 What Is Needed for Better Health Care: Better Systems, Better Patients or Both? Markus A. Feufel Gerd Antes Johann Steurer Gerd Gigerenzer J. A. Muir Gray Marjukka Mäkelä Albert G. Mulley David E. Nelson Jay Schulkin Holger Schünemann John E. Wennberg Claudia Wild 117

Health Illiteracy: Spread to the Public

9 Statistical Illiteracy in Doctors Odette Wegwarth Gerd Gigerenzer 137

10 Statistical Illiteracy in Journalism: Are Its Days Numbered? Bruce Bower 153

11 Improving Health Care Journalism Holger Wormer 169

12 Barriers to Health Information and Building Solutions Talya Miron-Shatz Ingrid Mühlhauser Bruce Bower Michael Diefenbach Ben Goldacre Richard S. W. Smith David Spiegelhalter Odette Wegwarth 191

Health Care 2020

13 How Can Better Evidence Be Delivered? Norbert Donner-Banzhoff Hilda Bastian Angela Coulter Glyn Elwyn Günther Jonitz David Klemperer Wolf-Dieter Ludwig 215

14 The Drug Facts Box: Making Informed Decisions about Prescription Drugs Possible Lisa M. Schwartz Steven Woloshin 233

15 Reengineering Medical Education David A. Davis 243

16 The Chasm between Evidence and Practice: Extent, Causes, and Remedies Richard S. W. Smith 265

17 The Future of Diagnostics: From Optimizing to Satisficing Henry Brighton 281

18 Direct-to-Consumer Advertising: Status Quo and Suggestions to Enhance the Delivery of Independent Medication Information Wolf-Dieter Ludwig Gisela Schott 295

19 How Will Health Care Professionals and Patients Work Together in 2020? A Manifesto for Change Ralph Hertwig Heather Buchan David A. Davis Wolfgang Gaissmaier Martin Härter Kai Kolpatzik France Légaré Norbert Schmacke Holger Wormer 317

Abbreviations 339

Glossary 343

Bibliography 347

Subject Index 387

What People are Saying About This

Endorsement

This impressive series of position pieces is excellent and essential reading for all those seeking to promote patient involvement and improve patient experiences of health care. It brings together leading thinkers, planners, and implementers in the field, and as one would expect from the title is genuinely visionary—challenging patients, clinicians, policy-makers, and journalists to adapt to a rapidly changing world and ways of doing health care.—Adrian G. K. Edwards , Department of Primary Care and Public Health, School of Medicine, Cardiff University

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From the Publisher

Health care needs an overarching goal that is shared by all stakeholders, and the one that is emerging is improvement of the value of care from the patients' perspective. This collection of papers from international experts explores the wide range of work that lies ahead, always thoughtfully and often brilliantly.—Thomas H. Lee , Network President, Partners Healthcare System, Boston

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This impressive series of position pieces is excellent and essential reading for all those seeking to promote patient involvement and improve patient experiences of health care. It brings together leading thinkers, planners, and implementers in the field, and as one would expect from the title is genuinely visionary—challenging patients, clinicians, policy-makers, and journalists to adapt to a rapidly changing world and ways of doing health care.—Adrian G. K. Edwards , Department of Primary Care and Public Health, School of Medicine, Cardiff University

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