Americans think many health care procedures are both better and less risky than they actually are. That’s according to a new meta-study in the Journal of the American Medical Association of surveys of patients’ expectations for various medical tests, screenings, and procedures. More:
Of the 34 outcomes with overestimation data available, the majority of participants overestimated benefit for 22 (65%) of them. For 17 benefit expectation outcomes, we could not calculate the proportion of participants who overestimated or underestimated, although for 15 (88%) of these, study authors concluded that participants overestimated benefits. Expectations of harm were assessed by 27 outcomes (across 13 studies): underestimation data were available for 15 outcomes and the majority of participants underestimated harm for 10 (67%) of these. A correct estimation by at least 50% of participants only occurred for 2 outcomes about benefit expectations and 2 outcomes about harm expectations.
These findings shed some light on another JAMA study that has been making the rounds recently. Ars Technica reports on this second study, which found that at teaching hospitals the mortality rate of heart attack patients declined from 24.8 percent to 17 percent when cardiologists were out of town at big medical conferences. The researchers don’t know why that happened, but Ars Technica lists three possible mechanisms. One is that the doctors who don’t attend the conferences are less likely to treat patients with “aggressive procedures.”We don’t have enough data to know whether the over-treatment thesis is correct, but if it is, it would be consistent with the conclusion of the first JAMA study: that medical procedures carry more risk than patients commonly suppose (and maybe more than doctors do, too). The prevalence of that too-rosy view suggests that we could use more information transparency in U.S. health care. Patients need better data not only about health care prices, but about the benefits and harms of procedures as well. And perhaps an appropriate New Year’s resolution for some Americans is: go to the doctor’s office less often.