The effect of simulated narratives that leverage EMR data on shared decision-making: a pilot study

Area of Science:

• Health Informatics
• Patient Decision Aids
• Clinical Communication

Background:

• Shared decision-making enhances patient satisfaction and outcomes.
• Patients require information on treatment risks and benefits for informed choices.
• The Hearts Like Mine (HLM) tool provides personalized treatment outcome information using EHR data.

Purpose of the Study:

• To evaluate the impact of simulated narratives within the HLM tool on patient decision-making.
• To assess whether narratives influence decisional confidence.
• To explore patient perceptions of narrative helpfulness in therapeutic decisions.

Main Methods:

• A pilot study involving 30 subjects using a block-randomized design.
• Comparison of HLM versions with and without simulated narratives for a hypothetical therapeutic decision.
• Measurement of decisional confidence using questionnaires post-decision.
• Statistical analysis included Chi-square and Mann-Whitney U tests.

Main Results:

• No statistically significant effect of simulated narratives on treatment decisions or decisional confidence was observed.
• Participants reported narratives were helpful in their decision-making process (mean score of 3.3/4).

Conclusions:

• Simulated narratives in the HLM tool did not measurably alter decisions or confidence levels.
• Despite no measurable effect, patients perceived narratives as helpful, indicating promise for shared decision-making.
• Narratives may support shared decision-making without introducing significant bias.