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H. Gilbert Welch, MD,MPH

JAMA. 2001;285:2776-2778.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I've always known shared decision making involves real work, but recently the challenge really hit home. A few days after I was invited to write this editorial, I visited my 80-year-old mother in Colorado. (Note: this is pure coincidence, both events are rare. . . . ) She had just learned that she had carotid artery stenosis. She was asymptomatic and was being asked to consider angiography and possibly surgery. Her physician and I wanted her to make an informed choice. She asked me to write the relevant information on a single sheet of paper, so she could read it, think about it, and read it again. I struggled with the assignment. The primary data source was clear: the ACAS (Asymptomatic Carotid Atherosclerosis Study)¹ and the mortality rate observed in the real world.²

But there were a lot of questions dealing with the 1-page presentation. My . . . [Full Text of this Article]

Screening Tends to Miss the Most Aggressive Cancers

Author Affiliations: Department of Veterans Affairs, White River Junction, Vt, and Center for Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH.

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