What is best for you and your family? This is often a difficult question for patients, caregivers and clinicians to answer. Investigators with the Knowledge and Evaluation Research (KER) Unit study the challenges that this question presents and ways of more appropriately answering it.
The answers are complicated for at least three reasons:
Evidence. What is best depends on what the options are and their favorable and unfavorable features. Research about the nature and likelihood of those features is key, but often leaves us uncertain because the evidence may be incomplete, biased, imprecise, irrelevant or inconsistent.
Our Evidence-Based Practice Research Program seeks to understand how we know what we know, what it is that we know, how trustworthy that knowledge is, and what our remaining knowledge gaps are. We focus on the evaluation of tests and treatments as well as on how care is organized and delivered, and we share what we find out with policymakers, clinicians and patients.
You. What is best depends on what you value, both in general and in this situation. What are your goals for health and health care? Given the options, what issues appear most salient to you right now? How do your goals relate with those options and their features, and how do we find what's right for you?
The Shared Decision-Making Program invents and tests tools that help patients and their clinicians have conversations that uncover what is best for each patient, right now. And then we work to ensure that the most helpful tools are available to anyone everywhere.
Situation. What is best depends on the situation. This not only means what is going on inside your body but also refers to the situation in which you are in, in relation to your loved ones, your community, your job and your life.
Our Minimally Disruptive Medicine Program works to shrink the health care footprint on people's lives. Many medical interventions need to play out their effects outside of the hospital and the clinic and inside your home, your workplace and your community. We aim to have health care fit into your routine, with minimal disruption to your life.
To get the care that is best for you and your family, we need health care that is careful — safe and of high quality in delivering the care that you need, not more and not less, just right, the first time. But we also need health care that is kind, that respects patients' limited resources, including time and energy, and that respects patient goals and aspirations.
That transformation cannot take place without patients mobilizing, through individual advocacy and collective action, to ensure that care remains the predominant value in health care. Find out more about our Patient Revolution initiative.