Laparoscopic performance after one night on call in a surgical department: prospective study.

vary in direction and magnitude, and are often specific for a given condition. Devereaux et al highlight potential biases that might account for the reported difference in responses in their study. These biases include non-blinded interviewers questioning each of the two groups separately (interviewer bias) and the fact that patients’ interviews lasted considerably longer (even with allowance for consent and the mini-mental test undertaken in the patient group alone). Furthermore, selection of patients who had no experience of either a stroke or side effects of treatment might bias their results. Patients who have experienced an episode of bleeding due to warfarin treatment report significantly lower quality of life scores. Many would argue that it is not surprising that differences in preferences for antithrombotic treatment were found. Patients seem to be older and have lower educational attainment than the doctors taking part in this study. Differences in characteristics between patients and doctors may have produced differences in preferences for antithrombotic treatment. This is precisely the reason why health professionals should explicitly seek patients’ views when they are making decisions about treatment. Unfortunately, asking patients about their preferences for treatment when decisions are being made on future management is often neglected by doctors. Important developments are likely to alter the dynamics of decision making between patients and doctors in the future. Information is now a freely available commodity. Initiatives such as the Cochrane collaboration actively promote consumer involvement and patient orientated information about medical effectiveness. Decision aids and other tools are being developed that will give patients access to information and allow them to express their preferences for treatment options. Some clinical guidelines explicitly express and quantify the impact of patients’ preferences on recommendations for treatment. The findings from this study show that health professionals should be sensitive to patients’ preferences and encourage the use of decision aids and information sources that can facilitate shared decision making.