Personalizing Medicine: Considering Preferences and Values

If you're interested in heart disease -- and who over the age of 40 isn't? -- you may have read an excellent series of articles by reporter Gina Kolata recently published in the New York Times. If you haven't seen it, the series includes pieces on blood pressure, stents, heart attack treatment and a new approach to aortic valve replacement. The heart valve article especially caught my eye, as this is a story I've been watching with personal interest: My 90-year-old mother has aortic stenosis for which surgery has been recommended. In fact, surgery was first recommended for my mom at least six years ago. I know that timing is correct because my sister Robin, an accomplished science and health journalist, described the decision-making process in writing in 2009. It's a thought-provoking piece, and I recommend it to all. (I show up in that piece in the role of "brother.") And the ensuing years -- which I will describe here -- provide a window on both scientific progress and the challenge of translating the best available evidence to make personal choices. As Robin noted, our mom was told in 2009 that if she didn't have the surgery, she had a 50 percent chance of dying within two years. At the time, I was skeptical of that prognosis -- not because it wasn't based on the best available evidence, but because the best available evidence wasn't any good. The only way to know the "natural history" of a condition such as aortic stenosis is to systematically record outcomes in every...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news