This study by Devereaux et al is an important addition to the expanding literature on shared decision making between patients and health professionals. It shows that patients may be more averse to the potential consequences of stroke and less bothered by the side effects of antithrombotic treatment than doctors are. It also shows that individual responses in both groups vary substantially. Responses for the minimum number of strokes that need to be prevented before warfarin is acceptable ranged from one to six for doctors and one to 11 for patients. For aspirin the figures were one to seven for doctors and one to eight for patients. Individual responses to the maximum number of excess bleeds that would be acceptable was even more diverse, ranging from one to 22 in both doctors and patients for both forms of antithrombotic treatment. These findings are consistent with other observational studies that have compared the preferences of patients and health professionals when they are faced with choices about treatment.
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