Supporting Shared Decisions When Clinical Evidence Is Low

Medical Care Research and Review - Tập 70 Số 1_suppl - Trang 113S-128S - 2013
Mary C. Politi1, Carmen L. Lewis2, Dominick L. Frosch3,4
11Washington University in St. Louis, St. Louis, MO, USA.
22University of North Carolina, Chapel Hill, NC, USA
3#N# 3Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
4#N# 4University of California, Los Angeles, Los Angeles, CA, USA

Tóm tắt

There is growing interest in shared decision making (SDM) in the United States and globally, at both the clinical and policy levels. SDM is typically employed during “preference-sensitive” decisions, where there is equipoise between treatment options with equal or similar outcomes from a medical standpoint. In these situations, patients’ preferences for the possible risks, benefits, and trade-offs between options are central to the decision. However, SDM also may be appropriate in clinical situations besides those in which data demonstrate equipoise. In situations of low evidence, where evidence is conflicting, unavailable or not applicable to an individual patient, supporting SDM can present unique challenges, above and beyond the challenges faced during more standard preference-sensitive decisions. This article discusses challenges in supporting shared decisions when clinical evidence is low, describes strategies that can facilitate SDM despite low evidence, and suggests avenues for future research to explore further these proposed strategies.

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Tài liệu tham khảo

American Cancer Society. (2010). American Cancer Society guidelines for the early detection of cancer. Retrieved from http://www.cancer.org/Healthy/FindCancerEarly/CancerScreeningGuidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer

10.1016/j.phr.2004.04.005

10.1097/00005650-200003000-00010

Association for Healthcare Research and Quality. (2011). Effective health care program: Explore your treatment options. Retrieved from http://www.effectivehealthcare.ahrq.gov/options/

10.3310/hta9380

10.1186/1748-5908-3-6

10.1001/jama.294.6.716

10.1186/1748-5908-3-38

10.1016/j.pec.2008.07.024

10.1016/S0277-9536(96)00221-3

Dale W., 2010, Paper presented at the Prevention and Control Research Seminar

10.1200/JCO.2008.18.5850

10.1200/JCO.1999.17.5.1601

10.2215/CJN.02040606

Decision Laboratory at Cardiff University. (2009). Option grids. Retrieved from http://www.optiongrid.co.uk/

Djulbegovic B., 2011, Journal of the American Medical Association, 305, 2005

10.1176/ps.2009.60.8.1007

Elwyn G., 2000, British Journal of General Practice, 50, 892

10.1186/1748-5908-4-75

10.1177/0272989X10386231

10.1136/bmj.c5146

10.1001/jama.291.19.2359

10.1056/NEJMp0911835

10.1001/jama.2009.984

10.1370/afm.1239

10.1001/jama.2009.1498

10.1093/jnci/djr318

10.1056/NEJMp0806233

10.1056/NEJMsb042979

10.1016/j.pec.2009.09.020

10.1177/0272989X10371830

10.1159/000126073

10.1177/009885880603200401

10.1186/1748-5908-3-34

10.1200/JCO.2006.09.2759

10.1016/j.pec.2008.07.018

10.1002/14651858.CD14006732.pub14651852

Legare F., 2007, German Journal for Quality in Health Care, 101, 213

10.1186/1472-6947-10-54

10.1177/0272989X07307271

10.1016/j.pec.2005.06.010

10.1016/j.socscimed.2006.09.013

Melbourne E., Joseph-Williams N., Elwyn G. (2011). Decision grid. Retrieved from http://www.decisionlaboratory.com/decision-grid.php

10.1001/jama.291.22.2720

National Comprehensive Cancer Network. (2007a). NCCN updates breast cancer risk reduction guideline. Retrieved from http://www.nccn.org/about/news/newsinfo.asp?NewsID=94

National Comprehensive Cancer Network. (2007b). NCCN Updates cancer- and treatment-related anemia guidelines. Retrieved from http://www.nccn.org/about/news/newsinfo.asp?NewsID=2125

10.1007/s12160-008-9037-8

10.17226/10883

10.1177/0272989X9501500105

O’Connor A. M., 2009, Cochrane Database of Systematic Reviews, CD001431

10.1136/bmj.319.7212.731

O’Connor A. M., Stacey D., Jacobsen M. (2011). Ottawa personal decision guide. Retrieved from http://decisionaid.ohri.ca/decguide.html

10.1177/10775587070640020301

10.1111/j.1369-7625.2010.00626.x

10.1177/0272989X07307270

10.1111/j.1365-2753.2010.01549.x

10.1353/hcr.2011.0029

10.1093/geronb/57.3.S135

10.1377/hlthaff.var.54

10.1016/j.pec.2006.08.007

10.1016/j.amepre.2003.09.011

10.1177/0272989X08326146

10.1111/j.1741-6787.2007.00108.x

10.3322/CA.2008.0006

10.1177/0272989X07307581

10.1016/S1470-2045(06)70941-X

10.1097/CCM.0B013E3181659096

10.1097/00005650-200209001-00006

United Kingdom Department of Health. (2010). Equity and excellence: Liberating the NHS. Retrieved from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117353

U.S. Office of the Legislative Counsel. (2010). Patient Protection and Affordable Care Act. Retrieved from http://docs.house.gov/energycommerce/ppacacon.pdf

U.S. Preventive Services Task Force. (2008). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Retrieved from http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm

U.S. Preventive Services Task Force. (2009). Screening for breast cancer: Recommendation statement. Retrieved from http://www.uspreventiveservicestaskforce.org/uspstf09/breastcancer/brcanrs.htm

Washington State Legislature. (2007). Shared decision-making demonstration project: Preference-sensitive care (RCW 41.05.033). Retrieved from http://apps.leg.wa.gov/rcw/default.aspx?cite=41.05.033

10.1001/jama.292.4.435

10.7326/0003-4819-140-1-200401060-00012

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Medical Care Research and Review

Tập 70 Số 1_suppl

113S-128S

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