Evidence-informed health care requires clinicians to combine their clinical experience with research evidence, in addition to the values of their patients.1,2 There is a complementary argument for participatory approaches that integrate clinical experience and patient values within evidence-informed clinical guidelines and standards of care. This melding of patients' values and evidence is challenging for two reasons. The first challenge is how to integrate, rather than choose between, these different forms of knowledge when making decisions about how services should operate. The second challenge is how to involve many clinicians and many service users in decisions with wide-reaching consequences. Making decisions collectively about priorities and standards raises questions about whom to involve and how, and about the evidence to inform these decisions.
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