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Making Informed Decisions for Better Health

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Health Outcomes: "What Makes You (Feel) Better" Medicine

While everyone might agree that improving healthcare and patient health are worthy goals, there must be a way to measure progress in reaching them. Medical science has turned to evaluating health outcomes as a means for determining the effectiveness of a medical test, procedure or treatment.

But what do we actually mean by "health outcomes"? The ultimate objectives of medicine are to help people who are sick to get better and to assist healthy people in preventing illness, while "doing no harm," as the famous phrase from the Hippocratic Oath cautions. Sickness or health, surviving or dying from a disease are examples of outcomes, but so are side effects experienced from treatments. "Health outcome" describes the end result or consequence of an action taken to prevent, manage or cure illness. The evaluation of health outcomes asks the basic question: "Are you better off than before medical intervention?"

Improving health outcomes through laboratory medicine is achieved with the appropriate use of testing. Laboratory tests should provide information that can improve a person's outcome. Sometimes, however, the evidence isn't always conclusive as to which tests or frequency of testing improves health outcomes, especially in the use of screening tests intended to prevent illness. [See "When Lack of Evidence or Consensus Warrants More Informed Decisionmaking"] Even the most authoritative organizations don't always agree on the elements of preventive care, such as the most appropriate age to begin routine screening or how often it should be repeated. In some cases, there is no consensus on whether screening with a particular test should be done at all.

Health outcomes rely, at least in part, on ensuring that laboratory tests are as accurate, sensitive and specific as possible, as well as reasonably available. Consider, though, that health outcomes also depend on what the practitioner and patient decide to do with the information supplied by test results. Action, or sometimes inaction, prompted by test results can have a substantial impact on a patient's health and the quality of care received.

Depending on the circumstances, testing decisions based on your preferences may expand the definition of health outcomes from not only "what makes you better" medicine, but to "what makes you feel better" medicine. While what makes you feel better may not necessarily improve your health status, it may improve your quality of life by reducing your anxiety, for example, and increasing your ability to enjoy yourself. Thus, patient-centered care may improve your health as well as the way you feel about your care. [See "When Patient Choice Outweighs Proven Advantages of Testing"]

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