Supporting Shared Decision Making When Clinical Evidence Is Low

Medical Care Research and Review - Tập 70 Số 1_suppl - Trang 129S-140S - 2013
Clarence H. Braddock1
1Stanford University, Stanford, CA, USA

Tóm tắt

Shared decision making (SDM) is the process of providing the patient with critical information that can support his or her informed participation in decision making. Shared decision making has become accepted as an important component of quality health care. Influenced by its foundations in law and ethics and by empirical work on its value as a tool to reduce variability in care, a perception has developed that SDM is relevant primarily to clinical situations with high-quality clinical evidence. This raises the question of the role of SDM in situations when clinical evidence is lacking or of low quality. This article posits that SDM is equally relevant and important to low-evidence situations in four ways—SDM fosters shared acceptance of uncertainty, closes the gap in knowledge between patient and physician, promotes patient empowerment, and enhances trust through transparent communication.

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Tài liệu tham khảo

10.1056/NEJMp1109283

Braddock C. H., 1998, American Journal of Medicine, 105, 354, 10.1016/S0002-9343(98)00271-X

Braddock C. H., 2000, Ethics in primary care, 239

10.1177/0272989X10381344

10.1001/jama.282.24.2313

Bursztajn H., 1990, Medical choices, medical chances

10.1001/jama.2009.984

Evans L., 2009, Family Medicine, 41, 319

10.1377/hlthaff.2011.0003

10.2307/3349705

10.1007/BF02250510

10.1146/annurev-psych-120709-145346

10.1001/jama.1995.03530220066035

10.1177/0272989X10393976

International Patient Decision Aid Standards Collaboration. (n.d.). IPDAS 2005: Criteria for judging the quality of patient decision aids. Retrieved from http://ipdas.ohri.ca/IPDAS_checklist.pdf

10.1007/BF02596120

10.1159/000126073

Katz J., 1984, The silent world of doctor and patient

10.1177/0272989X08327067

10.1001/archinte.1988.00380060149027

10.1111/1468-0009.00089

10.1016/S0277-9536(00)00014-9

10.1089/jwh.2008.1184

10.1377/hlthaff.26.3.716

10.1007/s00038-010-0212-x

10.1111/j.1365-2753.2010.01549.x

President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 1982, Making health care decisions: A report on the ethical and legal implications of informed consent in the patient-practitioner relationship

10.1177/0272989X08327066

10.1377/hlthaff.var.54

10.2975/32.4.2009.316.318

10.1056/NEJMsa0902321

10.1377/hlthaff.26.6.1564

10.1177/0272989X09353792

10.1097/MLR.0b013e31819a5acc