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Patient-Centered Outcome Spectrum: An Evidence-based Framework to Aid in Shared Decision-making
Angela M Ingraham1, Suresh K Agarwal, Hee Soo Jung
1University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, WI.
A new Patient-Centered Outcomes Spectrum (PCOS) tool synthesizes multiple risks into a composite measure for emergency general surgery (EGS) outcomes. This aids shared decision-making by providing a global understanding of patient health status post-EGS.
Area of Science:
- Surgical outcomes research
- Patient-centered care
Background:
- Current risk prediction tools for emergency general surgery (EGS) lack a composite measure for postoperative outcomes.
- A synthesized global measure is needed to improve shared decision-making between patients and providers.
Purpose of the Study:
- To develop an alternate construct for reporting anticipated outcomes after EGS.
- To present surgical risk using a composite measure.
Main Methods:
- Developed the Patient-Centered Outcomes Spectrum (PCOS) using the 2012-2014 American College of Surgeons National Surgical Quality Improvement Program data.
- Stratified patients (≥65 years) undergoing EGS by diagnosis and preoperative risk profile.
- Defined three exclusive global outcomes: good, intermediate, and bad.
Main Results:
- 46.4% of patients had good outcomes, 40.4% intermediate, and 13.2% bad outcomes.
- Outcome distribution varied significantly by risk profile: low-risk patients had 69.7% good outcomes, while high-risk patients had 29.1% bad outcomes.
- Diagnosis-specific PCOS constructs were also developed.
Conclusions:
- The PCOS offers an evidence-based, composite outcome measure for EGS.
- This tool supports shared decision-making by enhancing patient and provider understanding of surgical risks.
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