Abstract
Objective Shared decision making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known, however, regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases. Review Methods We searched for English-language studies (January 1, 1990, to August 9, 2015) evaluating use of SDM in elective surgical care where choice for surgery could be ascertained. Identified studies were independently screened by 2 reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7 of 24), followed by joint (5 of 24) and gynecologic surgery (4 of 24). Twenty studies used decision aids or support tools, including modalities that were multimedia/video (13 of 20), written (3 of 20), or personal coaching (4 of 20). Effect of SDM on preference for surgery was mixed across studies, showing a decrease in surgery (9 of 24), no difference (8 of 24), or an increase (1 of 24). SDM tended to improve decision quality (3 of 3) as well as knowledge or preparation (4 of 6) while decreasing decision conflict (4 of 6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 405-420 |
| Number of pages | 16 |
| Journal | Otolaryngology - Head and Neck Surgery |
| Volume | 154 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2016 |
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Keywords
- decision aid
- decision support tool
- elective surgery
- informed decision making
- shared decision-making
- systematic review
ASJC Scopus subject areas
- Otorhinolaryngology
- Surgery
Cite this
Shared decision making and choice for elective surgical care : A systematic review. / Boss, Emily; Mehta, Nishchay; Nagarajan, Neeraja; Links, Anne; Benke, James R.; Berger, Zackary; Espinel, Ali; Meier, Jeremy; Lipstein, Ellen A.
In: Otolaryngology - Head and Neck Surgery, Vol. 154, No. 3, 01.03.2016, p. 405-420.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Shared decision making and choice for elective surgical care
T2 - A systematic review
AU - Boss, Emily
AU - Mehta, Nishchay
AU - Nagarajan, Neeraja
AU - Links, Anne
AU - Benke, James R.
AU - Berger, Zackary
AU - Espinel, Ali
AU - Meier, Jeremy
AU - Lipstein, Ellen A.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective Shared decision making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known, however, regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases. Review Methods We searched for English-language studies (January 1, 1990, to August 9, 2015) evaluating use of SDM in elective surgical care where choice for surgery could be ascertained. Identified studies were independently screened by 2 reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7 of 24), followed by joint (5 of 24) and gynecologic surgery (4 of 24). Twenty studies used decision aids or support tools, including modalities that were multimedia/video (13 of 20), written (3 of 20), or personal coaching (4 of 20). Effect of SDM on preference for surgery was mixed across studies, showing a decrease in surgery (9 of 24), no difference (8 of 24), or an increase (1 of 24). SDM tended to improve decision quality (3 of 3) as well as knowledge or preparation (4 of 6) while decreasing decision conflict (4 of 6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.
AB - Objective Shared decision making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known, however, regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases. Review Methods We searched for English-language studies (January 1, 1990, to August 9, 2015) evaluating use of SDM in elective surgical care where choice for surgery could be ascertained. Identified studies were independently screened by 2 reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7 of 24), followed by joint (5 of 24) and gynecologic surgery (4 of 24). Twenty studies used decision aids or support tools, including modalities that were multimedia/video (13 of 20), written (3 of 20), or personal coaching (4 of 20). Effect of SDM on preference for surgery was mixed across studies, showing a decrease in surgery (9 of 24), no difference (8 of 24), or an increase (1 of 24). SDM tended to improve decision quality (3 of 3) as well as knowledge or preparation (4 of 6) while decreasing decision conflict (4 of 6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.
KW - decision aid
KW - decision support tool
KW - elective surgery
KW - informed decision making
KW - shared decision-making
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=84959300479&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959300479&partnerID=8YFLogxK
U2 - 10.1177/0194599815620558
DO - 10.1177/0194599815620558
M3 - Article
C2 - 26645531
AN - SCOPUS:84959300479
VL - 154
SP - 405
EP - 420
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
SN - 0194-5998
IS - 3
ER -