Diagnoses: The pivotal role of patient opinions

According to new research, experts recommend placing greater significance on patient perspectives during diagnoses, challenging the apparent current trend where clinicians often undervalue patient opinions

CREDIT: This is an edited version of an article that originally appeared on NHE

The recently conducted research by the University of Cambridge and King’s College London, focusing on neuropsychiatric lupus, revealed a startling trend – clinicians ranked patient self-assessment as the least influential factor in diagnoses, with fewer than 4% acknowledging its importance.

Despite clinicians often lacking confidence in diagnosing conditions with invisible symptoms like headaches, hallucinations, and depression, the study found that they tended to prioritise their own opinions over patient insights. Dr. Melanie Sloan, the lead author, emphasised the need to listen to patients, recognising their unique understanding of living with long-standing diseases.

Dr. Sloan also highlighted the challenge clinicians face in fully exploring each patient’s symptoms within the current constraints of healthcare systems, emphasising the importance of creating space for comprehensive patient-clinician discussions.

Nearly half (46%) of the 676 patients surveyed reported never or rarely being asked about their thoughts on their disease, revealing a significant disparity in patient engagement. However, positive experiences were noted, especially with nurses and psychiatrists who highly valued patient assessments.

Influence of characteristics on diagnosis:

The research suggested that factors such as ethnicity and gender could influence diagnoses. Male clinicians, in particular, were more likely to perceive patients as exaggerating their symptoms, highlighting potential biases.

Call for collaborative approaches

While acknowledging that patient views can sometimes be inaccurate, the authors argued that incorporating patient opinions into diagnoses could lead to fewer misdiagnoses and increased overall patient satisfaction. Dr. Tom Pollak from King’s College London stressed the importance of combining both patient and clinician views, especially when diagnostic tests may fall short.

Sue Farrington, Co-chair of the Rare Autoimmune Rheumatic Disease Alliance, urged a shift from the traditional ‘doctor knows best’ approach to a more equal patient-clinician relationship. She emphasised the need for collaborative efforts where patients’ lived experiences and clinicians’ learned experiences work hand-in-hand.

As we reconsider the dynamics of patient-clinician interactions, it becomes evident that fostering collaboration and valuing patient perspectives could revolutionise diagnoses, reduce misdiagnoses, and build stronger, more equitable healthcare relationships.