To the Editor.
—The article by Dr Goldzweig and colleagues1 and the accompanying Editorial by Dr Obstbaum2 address the utility of assessing patients' functional status relative to their lifestyle, but standardized patient input into the treatment decision deserves more emphasis. Shared decision making based on patient preferences is 1 mechanism suggested to document the need for therapy or surgery and to improve the quality of the decision.It has been shown than physicians are often incorrect when trying to guess patients' preferences,3 and there is convincing evidence that physicians and patients evaluate the usefulness of therapy differently. In the absence of a validated questionaire, the results of the patient-physician decision are not uniform, as indicated by the fact that regional rates of cataract surgery have been shown to vary significantly.
Prager TC, Urso RG, Ruiz RS. Cataract Extraction Rates and Insurance Status. JAMA. 1997;278(18):1489-1490. doi:10.1001/jama.1997.03550180039022