Question 14: Is it clear that there may be more than one possible treatment choice?
What the question is about and why it is important
A good quality publication will indicate that there is a choice
about treatment. The publication should indicate that the treatment choices
described may be suited to some people more than others, and that there is nearly always a
choice of treatment, even if a full account of alternatives has not been
presented in the publication.
Rating the question.
Your judgement will be important for rating this question. Consider the
publication as a whole and use the hints to help you decide whether it has highlighted the
issue of treatment choice for each consumer or patient.
Guidelines for rating the question:
5: Yes - the publication makes it very clear that
there may be more than one possible treatment choice.
2 - 4: Partially - the publication indicates that
there may be more than one possible choice, but the information is unclear or incomplete.
1: No - the publication does not give any indication
that there may be a choice about treatment.
A publication provides information about a new treatment for a form of
cancer. The treatment is reported to be the most effective treatment available for the
majority of people with this condition, and the authors describe the factors known to be
associated with good treatment outcomes (such as treatment at an early stage of the
disease and the absence of other medical conditions). The authors highlight some
unpleasant short-term side-effects associated with the treatment and the possibility that
a minority of patients may experience serious long-term consequences as a result of
treatment, including the development of other cancers. A brief description of the natural
progress of the disease and what is likely to happen without any treatment is also
included. Other treatments are mentioned briefly and the authors refer readers to several
other publications for more details. The authors conclude that they cannot recommend what
would be best for an individual patient.
A webpage describes a single treatment for a skin condition. The page is
written by a doctor and is found in the section on treatments on a national self-help
organisation's website. The sources of evidence quoted are the scientist who developed and
sells the treatment and the case of one of the doctor's patients who has experienced a
'miraculous' cure. The only reference to other treatment choices is the statement that
'all other treatments for the condition are associated with unacceptable side-effects' and
the possibility of 'permanent disfigurement' if no treatment is used. The patient's search
for a cure is described as 'torture' that led him to try other treatments that left him
'scarred' and 'suicidal'. The treatment is said to produce 'stunning and permanent results
after a few applications with no risks or side-effects'. The author recommends the
treatment as 'suitable for anyone' and 'bringing hope to all those who have despaired of
finding relief from this devastating and unsightly condition'.