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Whose Preferences Matter? A Patient-Centered Approach for Eliciting Treatment Goals.
Nananda F Col1, Andrew J Solomon2, Vicky Springmann1
1Five Islands Consulting LLC, Georgetown, ME (NFC, VS, BT, AH).
Summary
Patient and healthcare provider treatment goals for multiple sclerosis (MS) differ significantly. This study used cognitive mapping to develop a patient-centered approach for eliciting treatment preferences, minimizing bias.
Area of Science:
- Patient-centered care
- Decision-making in healthcare
- Multiple Sclerosis (MS) management
Background:
- High-stakes clinical decisions require incorporating patient preferences and clinical characteristics.
- Current preference-assessment tools often rely on investigator-selected outcomes, potentially overlooking patient priorities.
Purpose of the Study:
- To develop a patient-centered method for eliciting and comparing treatment goals between patients with multiple sclerosis (MS) and healthcare providers (HCPs).
Main Methods:
- Five nominal group technique (NGT) meetings were conducted with patients and HCPs.
- Participants identified and prioritized treatment goals.
- Multidimensional scaling and hierarchical cluster analysis created cognitive maps to visualize goal relationships.
Main Results:
- 34 unique patient goals and 31 unique HCP goals were identified.
- Patients prioritized symptom impact on daily life; HCPs focused on disease progression.
- Distinct clusters emerged for patient and HCP goals, highlighting differing priorities.
Conclusions:
- Discrepancies in goals emphasize limitations of investigator-defined outcomes.
- Cognitive mapping offers a patient-centered approach to identify and organize treatment goals for values clarification.
- This method minimizes bias and maximizes patient relevance in treatment decision-making.
Keywords:
clinical decision makingcognitive mappinghierarchical cluster analysismultidimensional scalingmultiple sclerosisnominal group techniquepreference assessmentpreference sensitive careshared decision makingvalues clarificationMore Related Videos
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