Community Forum Deliberative Methods Demonstration: Evaluating Effectiveness and Eliciting Public Views on Use of Evidence - Executive Summary

Public perceptions of comparative effectiveness research and use of evidence in healthcare decision-making

“…Members of the public are also healthcare consumers at some point in time, whether they are seeking healthcare for themselves, family members or someone else in their lives. Research suggests that members of the public view evidence as important to quality healthcare and yet individual preferences or physician judgment can carry more weight than evidence in making decisions [8]. Healthcare consumers believe doctors have a responsibility to be educated about the evidence [8] and to provide information and guidance to patients [8][9][10].…”

“…Research suggests that members of the public view evidence as important to quality healthcare and yet individual preferences or physician judgment can carry more weight than evidence in making decisions [8]. Healthcare consumers believe doctors have a responsibility to be educated about the evidence [8] and to provide information and guidance to patients [8][9][10]. Some evidence also suggests that the public believes that patients are ultimately responsible for making informed healthcare choices [8], yet consumers often have limited knowledge and ability to make informed medical decisions [11].…”

“…Healthcare consumers believe doctors have a responsibility to be educated about the evidence [8] and to provide information and guidance to patients [8][9][10]. Some evidence also suggests that the public believes that patients are ultimately responsible for making informed healthcare choices [8], yet consumers often have limited knowledge and ability to make informed medical decisions [11]. Even among consumers who express trust in their physician and consider themselves to be informed about medical evidence, research suggests actual factual knowledge may still be low [10].…”

What factors determine the choice of public engagement undertaken by health technology assessment decision-making organizations?

“…No definitive conclusions could be reached due to methodological limitations (Nilsen, Myrhaug, Johansen, Oliver, & Oxman 2006). The randomized trial conducted by the AHRQ EHCP cited earlier (Carman KL et al 2013b) found each deliberative method was effective in increasing knowledge; however community deliberation and citizens' panel techniques may be more appropriate for more complex topics. Other similar research projects are ongoing (Gagnon et al 2012) and our understanding of strengths and weaknesses of different public engagement approaches is likely to improve with the increasing interest in patient centered policymaking and practice (Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI 2012)).…”

The Big Picture

“…Indeed, some studies, mostly conducted in health policy contexts, have compared deliberation, education-only, and measurement-only control groups or survey, interview, or discussion procedures. These studies often find greater change in knowledge and/or attitudes when deliberative methods are used instead of other methods (Abelson et al, 2003;Barabas, 2004;Carman et al, 2014;De Vries et al, 2010;Kim et al, 2011). However, other studies, such as Denver, Hands, and Jones's (1995) study of deliberative poll participants in the UK, find no change in knowledge or attitudes, and yet others suggest deliberation may facilitate the biased strengthening of pre-existing attitudes (Kahan, 2012;Sunstein, 2002).…”