Do the public share practitioners' views about the best evidence?

Area of Science:

• Medical decision-making
• Evidence-based practice
• Health literacy

Background:

• General practitioners (GPs) and patients may have differing views on the hierarchy of evidence for treatment effectiveness.
• Understanding these differences is crucial for effective shared decision-making in clinical practice.

Purpose of the Study:

• To compare the perceived value of different sources of evidence for treatment effectiveness between GPs and the general public.
• To identify potential discrepancies in how evidence is weighted by healthcare providers and patients.

Main Methods:

• GPs and members of the public (aged 18-83) evaluated five treatment scenarios.
• Scenarios presented evidence from randomized controlled trials (RCTs), audits, single doctor's experience, friend's experience, or web sales sites.
• Participants rated their confidence in the effectiveness of the more successful treatment based on the provided evidence.

Main Results:

• All participants distrusted web-based sales sites the most.
• Confidence increased with evidence from a friend's experience, then a single doctor's experience.
• General public showed some age-related differences, but only GPs prioritized RCTs as the most trusted evidence source.

Conclusions:

• GPs may consider RCTs the gold standard for treatment evidence, a view not necessarily shared by patients.
• Shared decision-making requires GPs to acknowledge and address potential patient skepticism towards evidence hierarchies, particularly RCTs.
• Awareness of differing evidence valuation is essential for improving patient-provider communication and treatment adherence.