Patients perspectives: Ideas, concerns and expectations

Its actually ICEFE

Ideas
Concerns
Expectations
Feelings
Effects

csa - diagnosing the patient perspective (ICE).pptx

Diagnosing the patient's preferences involves understanding their perspective

Stop the silent misdiagnosis: patients’ preferences matterCorrect treatment recommendations require accurate diagnosis not only of the medical condition but of patients’ treatment preferences. Al Mulley , Chris Trimble , and Glyn Elwyn outline how to ensure that preferences are not misdiagnosed In recent decades, rapid advances in the biosciences have delivered an explosion of treatment options. This is good news for patients, but it makes medical decision making more complicated. Most critically, an accurate medical diagnosis is no longer sufficient to identify the proper treatment. Just as important is an accurate preference diagnosis.1 Every option for treatment (a term that we use broadly here, to include procedures, tests, and even watchful waiting) has a unique profile of risks, benefits, and side effects. Doctors, generalists as well as specialists, cannot recommend the right treatment without understanding how the patient values the trade-offs. Regrettably, patients’ preferences are often misdiagnosed. We outline a method for making better preference diagnoses. “Listen to the patient: he is telling you the diagnosis,” William Osler urged students he taught at Johns Hopkins and Oxford more than a century ago. Osler knew that the patient’s story was often critical to an accurate diagnosis. Like many of his contemporaries, Osler saw diagnosis as the medical profession’s foundational skill. The right treatment, after all, depended on the right diagnosis. Generations later, skill in diagnosis remains a source of professional pride for many physicians, while the spectre of a misdiagnosis or missed diagnosis can provoke sleepless nights. Medicine has changed since Osler’s day, in that there are now more diagnostic technologies and more treatment options. Although the rising accuracy of diagnostic tests has allowed doctors to rely less on listening when determining the cause of symptoms,2 listening is growing in importance when deciding which of the many treatment options best fits each patient’s priorities. The …

Medical misdiagnosis versus preference misdiagnosis

Doctors believe that 71% of patients with breast cancer rate keeping their breast as a top priority, but the figure reported by patients is just 7%
Doctors believe that 96% of breast cancer patients considering chemotherapy rate living as long as possible a top priority, while the figure reported by patients is 59%

Once patients become well informed, however, they frequently change their decisions:

A randomised trial of a decision aid for coronary heart disease in Toronto showed a relative reduction in preference for surgical treatment of more than 20% (an absolute reduction from 75% to 58%) for patients with stable angina

“Listen to the patient: he is telling you the diagnosis,” William Osler

Patient experience in the NHS services: NICE guidance

https://www.nice.org.uk/guidance/cg138

Listen to and address any health beliefs, concerns and preferences that the patient has, and be aware that these affect how and whether they engage with treatment (NICE)