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In Reply Melis and colleagues comment on our finding that patient preference for involvement in decision making among hospitalized patients is associated with increased hospital length of stay and costs and note that this contradicts the expectation that greater patient engagement will reduce resource use.1 They say that preference for involvement may not be associated with actual levels of involvement. However, while preferred and actual levels of involvement may diverge, patient preference for greater involvement still tends to be positively associated with the actual level of involvement.2,3
Meltzer DO, Ruhnke GW, Tak HJ. Actual Involvement vs Preference for Involvement as an Indicator of Shared Decision Making—Reply. JAMA Intern Med. 2014;174(4):644. doi:10.1001/jamainternmed.2013.12840