From decision to shared-decision: Introducing patients' preferences into clinical decision analysis

Area of Science:

• Health Informatics
• Clinical Decision Support
• Patient-Centered Care

Background:

• Patient preferences are crucial in healthcare decision-making.
• Clinical practice guidelines often require patient involvement for optimal care.
• A shift towards patient-oriented shared decision-making (SDM) is needed.

Purpose of the Study:

• To propose a unified framework for personalized, patient-oriented shared decision-making (SDM).
• To integrate decision models and patient preference elicitation into a single tool for clinical use.
• To facilitate the use of evidence-based medicine and SDM in clinical encounters.

Main Methods:

• Developed a framework with theoretical, technological, and architectural components.
• Encapsulated decision models and patient preference instruments into a unified tool.
• Implemented and tested the framework in a case study on thromboembolism risk in atrial fibrillation.

Main Results:

• Demonstrated framework implementation for personalized decision models in atrial fibrillation.
• Pilot study with 20 patients showed personalized models differ significantly from population-based ones.
• Highlighted the importance of tailoring decision models to individual patient preferences.

Conclusions:

• The framework can overcome physician-perceived barriers to adopting SDM.
• It enhances patient involvement in care by focusing on individual needs.
• Promotes a more personalized and patient-centered approach to clinical decision-making.