Incorporating Patients' Preferences into Medical Decisions

As our medical decisions become more and more standardized and codified, we should take care to ensure that critical therapeutic choices are not based exclusively on formal guidelines. Many decisions need to be individualized, especially when they involve choices between possible outcomes that may be viewed differently by different patients. In such cases we should identify a patient's preferences scrupulously -- a point underscored by O'Meara and colleagues in this issue of the Journal 1 . They present a decision analysis of the choice between heparin alone and streptokinase plus heparin in the treatment of deep venous thrombosis. The result helps . . .