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Comment & Response
February 13, 2019

Cost and Outcomes Information Should Be Part of Shared Decision Making

Author Affiliations
  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
  • 2Microsoft, Redmond, Washington
  • 3Tuck School of Business, Dartmouth College, Hanover, New Hampshire
  • 4Kellogg School of Management, Northwestern University, Evanston, Illinois
  • 5Center for Shared Decision Making, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
JAMA Surg. Published online February 13, 2019. doi:10.1001/jamasurg.2018.5581

To the Editor We applaud Kopecky et al1 for articulating that a shared decision-making process for determining whether to obtain a preference-sensitive elective surgery requires more than asking a patient to watch a video, read a document, or fill in numbers on a risk calculator. Clearly, a surgeon should agree that the surgery is a reasonable treatment option, be able to modify treatment recommendations based on a patient’s risk profile, and weigh in on what the surgeon believes to be the best treatment pathway. Along the way, patients should be informed of the short-term and long-term risks and benefits of different treatment options, including adverse effect profiles that might influence decision making for reasonable patients with distinct sets of values.

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