Impact of patient preferences on the selection of therapy

To make intelligent choices among therapeutic alternatives, physicians must compare the effectiveness of various therapies. Traditional measures of effectiveness, such as the 5-yr survival rate and the life expectancy, ignore patient preferences. Because patient attitudes can, however, have a major impact on the relative worth of therapy, we have adapted the techniques of utility theory to integrate those attitudes with objective survival data. The importance of variations in patient attitudes toward survival is illustrated in a typical situation involving the choice between medical and surgical therapy.