Evidence That Consumers Are Skeptical About Evidence-Based Health Care

Abstract

We undertook focus groups, interviews, and an online survey with health care consumers as part of a recent project to assist purchasers in communicating more effectively about health care evidence and quality. Most of the consumers were ages 18-64; had health insurance through a current employer; and had taken part in making decisions about health insurance coverage for themselves, their spouse, or someone else. We found many of these consumers' beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as "medical evidence" or "quality guidelines." Most believed that more care meant higher-quality, better care. The gaps in knowledge and misconceptions point to serious challenges in engaging consumers in evidence-based decision making.

An exploration of individuals’ preferences for nutrition care from Australian primary care health professionals

“…Patients consider multiple factors when selecting a health professional or health service, including the convenience, trust and accessibility of the professional or service, and recommendations provided by family and friends (Schwartz et al 2005;Wun et al 2010). Interestingly, patients generally do not consider the effectiveness of a service or the reliance on evidencebased health care practices when selecting a health professional or health service (Bornstein et al 2000;Carman et al 2010).…”

An Official American Thoracic Society Research Statement: Comparative Effectiveness Research in Pulmonary, Critical Care, and Sleep Medicine

“…In some areas of the world (e.g., the United Kingdom), a combination of clinical and cost effectiveness is considered before making therapies broadly available in clinical practice (35). In the United States (36)(37)(38), there is little public support for the use of cost effectiveness for decision making, because it may reduce options available to patients and providers (39). By statute, PCORI is not allowed to fund cost-effectiveness studies, or studies in which cost is an outcome measure (even if cost is specified as a secondary outcome) (36,40).…”

Engaging the Public in Decisions about Health Research—The Role of Public Deliberation

“…Evidence from medical research is often less than conclusive, and policies based on evidence may imply tradeoffs regarding the distribution of risks and benefits across society, tensions between short-term and long-term outcomes, and a range of effects on quality of life, among other considerations and consequences [15,36]. Recommendations and guidelines designed to improve health care based on research may conflict with public perceptions of quality care and meet with suspicion [37]. Effective use of health care research depends on understanding and consideration of public values and perceptions, in addition to the development of scientifically valid research results.…”