Until a formal methodology for defining the individual's value system is clearly established, nephrologists will continue to be forced to rely on their intuition about patients’ values.

Physicians currently lack a reproducible and rigorous technique to describe patient values with accuracy and precision, and to integrate what they have learned about those values with biomedical information about the patient. Consequently, other, better-defined outcomes, such as mortality and hospitalization rates remain the almost exclusive basis for decision-making.