Measuring patients' preferences for treatment and perceptions of risk.

A greater understanding of patients’ preferences for mode of treatment is central to current models of shared patient-doctor decision making. It is also of potential importance in enhancing patient adherence to treatment and, in turn, patients’ health outcomes. Health services, with their emphases on patient involvement and satisfaction, audit and clinical governance, increasingly aim to be responsive to patients’ concerns and ultimately to enhance the quality of health care. Hence there is a need for awareness of patients’ preferences for treatment, and to develop appropriate, valid and reliable methods of eliciting these. The papers published in this supplement represent the output of an MRC Health Services Research Collaboration (HSRC) workshop, together with invited papers from other researchers in the area of patients’ preferences for treatment. The MRC HSRC has a special interest in the individualisation of health care and in methodological development; it is in the interface between patient preferences and evidence of benefit derived from groups that individualisation of care may be achieved. The aim of the workshop was to bring together an interdisciplinary group of UK experts to discuss the concept and measurement of patients’ preferences for treatment and directions for future research. The complexity and possible directions for research are summarised in fig 1. The supplement covers patients’ understandings of treatment risks, patients’ inclusion in decision making about treatment, diVerences in treatment preferences between doctors, and between doctors and patients, as well as methodological and ethical issues. It indicates the need for interdisciplinary collaboration on this topic. The literature on preferences spans a wide range of disciplines and journals including medicine, epidemiology, ethics, psychology, sociology, economics and policy areas from transport and environmental planning to agriculture. The knowledge base in this area of work is thus very diVuse which makes it diYcult for those with unidisciplinary approaches to become aware of all relevant research. It is intended that this collection of papers should stimulate further multidisciplinary dialogue, with involvement of representatives of patients, on the definition and measurement of patients’ preferences for treatment and their perception of its risks.