A design process for using normative models in shared decision making: a case study in the context of prenatal...

Area of Science:

• Decision Analysis
• Medical Informatics
• Health Communication

Background:

• Shared decision making (SDM) aims to involve patients actively in treatment choices.
• Current communication methods struggle to accurately gauge patient preferences during consultations.
• Patients seeking greater involvement in medical decision making (MDM) face challenges in expressing their preferences effectively.

Purpose of the Study:

• To enhance patient-physician communication quality through a novel SDM design process.
• To demonstrate the application of this process using a normative model in a specific medical context.
• To improve the utilization of normative models in clinical practice.

Main Methods:

• Defined the medical situation and decision problem.
• Developed/identified and adapted a normative model.
• Conducted empirical analysis and developed decision support systems (DSS) tools.
• Applied the general normative theory of MDM under uncertainty to a medical-financial dilemma.

Main Results:

• A systematic design process for SDM was established.
• The process was demonstrated through a case study on choosing a physician for amniocentesis.
• Decision support systems (DSS) were developed to facilitate SDM.

Conclusions:

• Implementing normative models in SDM presents challenges regarding model goals and prediction vs. recommendation.
• The validity of using normative models for individuals not adhering to their assumptions requires further consideration.
• The study highlights the complexities in integrating normative decision theory into practical SDM.