Uncertainty in making decisions about health care
Identifying important areas of uncertainty in the treatment or management of urinary incontinence
The MS Trust has been working with the James Lind Alliance to identify 'clinical uncertainties' in the management of bladder problems.
Every day patients, carers and clinicians have to make choices between different treatments or different methods of management for health problems. The choice made can have an important impact on the life of the person involved. Therefore it is best if information based on up to date research is available which patients, carers and clinicians can discuss together to help them make the right choice.
But sometimes not enough up to date information exists and as a result patients, carers and clinicians are faced with uncertainty regarding the best choice to make. The James Lind Alliance calls these situations 'clinical uncertainties' - questions and choices in the treatment or management of bladder control problems which cannot currently be informed by up to date information based on research evidence.
The Alliance wants to identify bladder problems and treatments where there is not enough information available to help people come to a decision. When this has been done so, the information can be used to ensure that future research addresses these issues. This will be a great help for similar people facing the same decisions in the future.
What can be done about this?
The James Lind Alliance Working Partnership on Urinary Incontinence is a partnership of organisations representing patients, carers and clinicians.
Its aim is for patients, carers and clinicians to work together to:
- identify important areas of 'clinical uncertainty';
- assemble and publish these in the Database of Uncertainties about the Effects of Treatments (DUETS);
- decide which of these uncertainties are most important.
Many people with MS have already helped us by responding to a questionnaire on such uncertainties. The next step involves sifting, collating and ranking the clinical uncertainties identified into a report. This document will then be published and sent to organisations which fund research, to promote the search for evidence which will make it easier for people to make well informed decisions about treatment.
- Read a report by the MS Trust's representative on the project - February 2009
The James Lind Alliance is supported by the Medical Research Council and the Department of Health.