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Ethical Dilemmas II

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Related Experiment Videos

Is there shared decision making when the provider makes a recommendation?

Marissa Frongillo¹, Sandra Feibelmann, Jeff Belkora

¹Department of General Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. mfrongillo@partners.org

Patient Education and Counseling

|September 25, 2012

Summary

This summary is machine-generated.

When providers avoid making recommendations, breast cancer patients engage more in shared decision-making. Discussing all options, including mastectomy and lumpectomy, is crucial for patient involvement.

Related Experiment Videos

Area of Science:

Oncology
Health Services Research
Patient-Provider Communication

Background:

Shared decision-making (SDM) is vital in breast cancer treatment choices.
Understanding factors influencing SDM, such as provider recommendations, is essential.

Purpose of the Study:

To compare the level of shared decision-making in breast cancer surgery consultations.
To determine if provider treatment recommendations impact SDM.

Main Methods:

Surveyed breast cancer survivors eligible for mastectomy or lumpectomy.
Assessed patient-reported provider recommendations and discussion of options, risks, and benefits.
Calculated a total involvement score to quantify SDM.

Main Results:

85% of patients received a provider recommendation.
Patients without recommendations showed higher SDM scores (52% vs. 39.1%, p=0.004).
Receiving differing recommendations (65.5%) yielded higher SDM than specific mastectomy (42.5%) or lumpectomy (33.2%) recommendations (p<0.001).

Conclusions:

Provider recommendations can decrease balanced discussion of surgical options.
Lumpectomy recommendations were associated with the lowest patient involvement.
Eliciting patient goals and preferences is key, irrespective of recommendation.