A problem for achieving informed choice
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Most agree that, if all else is equal, patients should be provided with enough information about proposed medical therapies to allow them to make an informed decision about what, if anything, they wish to receive. This is the principle of informed choice; it is closely related to the notion of informed consent. Contemporary clinical trials are analysed according to classical statistics. This paper puts forward the argument that classical statistics does not provide the right sort of information for informing choice. The notion of probability used by classical statistics is complex and difficult to communicate. Therapeutic decisions are best informed by statistical approaches that assign probabilities to hypotheses about the benefits and harms of therapies. Bayesian approaches to statistical inference provide such probabilities.
KeywordsClassical statistics Bayesian statistics Informed choice Informed consent Randomised controlled trials
Thanks to Jason Grossman and Mark Colyvan for helpful discussion and comments on earlier drafts. I would also like to thank two anonymous referees of Theoretical Medicine and Bioethics.
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