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<h4>Any progress made to move decision <br>making closer to the patient is desireable<br> for all the same reasons that skydivers <br>like to pack their own parachutes.</h4>

Any progress made to move decision
making closer to the patient is desireable
for all the same reasons that skydivers
like to pack their own parachutes.

Planning with Confidence

Decision Aids help us control our medical treatment destinies

There is an urban legend that says that recreational parachutists are required to pack their own parachutes. As the legend goes this is because no one but the jumper wants to take on the responsibility for the consequences of it being packed incorrectly. The reality is somewhat more complex, however like all urban legends it carries with it a grain of human truth.

Decision making about medical treatment is an activity where errors can lead to a tremendous negative impact. Any progress made to move decison making closer to the patient is desirable for all the same reasons that skydivers like to pack their own parachutes.

If you would consider for a moment, decision-making is in fact central to the entire health care delivery process.

Every treatment delivered, every test performed, is carried out in response to an evaluation process that takes into account: patient information; patient values; medical knowledge; and knowledge about how the health care system works.

This evaluation process is what blends information from all four sources into what we have to believe are the best decisions possible.

Any process that improves medical treatment decision-making will necessarily enhance the quality of our entire health care system.

Computer Based Decision Aids is an emerging area of technology that is promising to provide the decision making support that human health care workers do not always have the time or the skills to provide directly.

One of Canada's leaders in this area is Dr. Annette O’Connor, Senior Scientist at the Ottawa Health Research Institute (OHRI), and one of her professional roles is to help develop standards for the development and evaluation of computer based decision aids. These software tools are being used by both patients and physicians, to provide structure to the process of blending values and knowledge into decisions that everyone can remain satisfied with.

Dr. O’Connor explained that:

“With the traditional medical decision making process a patient may have fifteen minutes with the medical specialist that holds the bulk of the information about their condition and their treatment options. What happens during this 15 minutes is that the patient must gather and evaluate the medical information from the physician and the physician must gather and evaluate value set information from the patient.

In the end the physician makes either a strong recommendation, or provides a limited set of choices based on their understanding of the medical facts and the patient's needs and values.

When we’ve followed up on some of these conventional processes using our decision aid techniques we found that nine times out of ten the physician misread the true values held by the patient and consequently the decision reached could have been less than optimal.”

The OHRI decision aid web site http://decisionaid.ohri.ca is a portal to the online world of computer based decision support. The web site currently provides links to hundreds of online decision aids which can help you make better decisions about diverse conditions ranging from Acne to Warts with Breast Cancer and Lower Back Pain in between.

One of the most enlightening tools provided on the OHRI website is their “Personal Decision Guide” which you can use to help structure the process of making any decision in you life, from, whether to date that hot guy at the office to how much money to invest in this year’s RRSPs. This generic tool will help you to better understand how to structure the process of gathering information and clarifying values in order to reach decisions that fill your real needs.

For access to the free general OHRI decision aid tool see: decisionaid.ohri.ca/decguide.html


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