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Systematic review of shared decision-making in surgery
S M L de Mik1, F E Stubenrouch1, R Balm1
1Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
The British Journal of Surgery
|October 26, 2018
Summary
Shared decision-making (SDM) in surgery is underutilized, with only 36% of consultations perceived as SDM. Patients reported higher SDM levels than surgeons, indicating a need for improved assessment and interventions.
Area of Science:
- Medical decision-making
- Surgical patient care
Background:
- Multiple treatment options exist for most diseases.
- Shared decision-making (SDM) aligns treatments with patient preferences.
- SDM is crucial for patient-centered surgical care.
Purpose of the Study:
- To assess the application of SDM in surgical consultations.
- To identify metrics used for measuring SDM and its outcomes in surgery.
Main Methods:
- Systematic review of observational studies and clinical trials.
- Searched Embase, MEDLINE, and CENTRAL databases.
- Independent data extraction and quality assessment by two investigators.
Main Results:
- 32 articles included, measuring SDM with nine metrics.
- Only 36% of 13,176 patients/surgeons perceived consultations as SDM.
- Objective SDM scores ranged from 7-39%, subjective scores from 54-93%.
Conclusions:
- SDM in surgery is nascent but viewed favorably by patients and surgeons.
- Further research needed on interventions to enhance SDM in surgical settings.
- Validated metrics are essential for accurate SDM assessment in surgical consultations.
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