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shared decision making; patient preferecnce

An approach to making medical decisions that combines a physician's expertice in the medical domain with the patient's knowledge of his/her wishes/values in order to make decisions in the patient's best interest. This approach is especially indicated when evidence about the best management strategy is equivocal. Notes: - shared decision making can cut antibiotic use in half [2] & improve patient satisfaction [3] - shared decision making leads to - less invasive procedures - improved patient satisfaction* - lower costs [9] - more time spent with each patient - less attention paid to quality measures [9] - use of option grids may facilitate shared decision making [5] - studies are limited, results are inconsistent, & clinical implications are unclear* [7] - shared decision-making with lung cancer screening falls short [10] * patient satisfaction may be associated with worse outcomes - quality measures conflict with shared decision making [9] - if outcomes assessed in part by quality measures, association of patient satisfaction with outcomes requires context- dependent interpretation

General

decision making

References

  1. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  2. Legare F et al Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial CMAJ July 30, 2012 PMID: 22847969 https://mail.google.com/mail/u/0/?tab=wm#inbox/138dcb2105d9dfb9
  3. Merenstein D et al. An assessment of the shared-decision model in parents of children with acute otitis media. Pediatrics 2005 Dec; 116:1267-75 PMID: 16322146
  4. Mulley AG et al Stop the silent misdiagnosis: patients' preferences matter. BMJ 2012;345:e6572 PMID: 23137819 http://www.bmj.com/content/345/bmj.e6572
  5. Option Grids are brief tools to help patients take part in making decisions. (Option grids available as PDF) Decision Laboratory, Institute of Primary Care & Public Health Cardiff University http://www.optiongrid.co.uk/
  6. Delbanco T et al. Inviting patients to read their doctors' notes: A quasi-experimental study and a look ahead. Ann Intern Med 2012 Oct 2; 157:461. PMID: 23027317
  7. Fowler FJ Jr et al. How patient centered are medical decisions? Results of a national survey. JAMA Intern Med 2013 May 27 PMID: 23712194 http://archinte.jamanetwork.com/article.aspx?articleid=1691770 - Krumholz HM et al. Decision-making preferences among patients with an acute myocardial infarction. JAMA Intern Med 2013 May 27 PMID: 23712775 http://archinte.jamanetwork.com/article.aspx?articleid=1691767
  8. Han PK et al National Evidence on the Use of Shared Decision Making in Prostate-Specific Antigen Screening. Ann Fam Med July/August 2013 11:306-314 PMID: 23835816 http://www.annfammed.org/content/11/4/306.full - Wilkes MS et al Pairing Physician Education With Patient Activation to Improve Shared Decisions in Prostate Cancer Screening: A Cluster Randomized Controlled Trial. Ann Fam Med July/August 2013 vol. 11 no. 4 324-334 PMID: 23835818 http://www.annfammed.org/content/11/4/324.full - Feng B et al Physician Communication Regarding Prostate Cancer Screening: Analysis of Unannounced Standardized Patient Visits. Ann Fam Med July/August 2013 vol. 11 no. 4 315-323 PMID: 23835817 http://www.annfammed.org/content/11/4/315.full - Ferrer RL and Gill JM Shared Decision Making, Contextualized. Ann Fam Med July/August 2013 vol. 11 no. 4 303-305 PMID: 23835815 http://www.annfammed.org/content/11/4/303.full
  9. Frieden J. Place More Value on Talking with Patients, Experts Say. Shared decision-making works well, but requires time. MedPage Today. September 26, 2017 https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/68158
  10. Brenner AT, Malo TL, Margolis M et al Evaluating Shared Decision Making for Lung Cancer Screening. JAMA Intern Med. Published online August 13, 2018. PMID: 30105393 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2696731 - Redberg RF Failing Grade for Shared Decision Making for Lung Cancer Screening. JAMA Intern Med. Published online August 13, 2018. PMID: 30105372 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2696725
  11. Goodwin JS, Nishi S, Zhou J et al Use of the Shared Decision-Making Visit for Lung Cancer Screening Among Medicare Enrollees. JAMA Intern Med. Published online January 14, 2019. PMID: 30640388 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2720126
  12. Mayo Clinic. Shared Decision Making. http://shareddecisions.mayoclinic.org/