Assessing Differences in Cancer Surgeon Approaches to Patient-Centered Decision-Making Using Vignette-Based...

Area of Science:

• Medical Decision Making
• Surgical Practice
• Health Services Research

Background:

• Assessing patient-centered decision-making (PCDM) strategies is crucial for understanding surgeon and patient influences.
• Previous research has not fully elucidated the factors affecting surgeon adoption of PCDM.

Purpose of the Study:

• To evaluate surgeon-patient-centered decision-making (PCDM) strategies in relation to surgeon and patient characteristics.
• To identify surgeon and patient factors that influence the utilization of PCDM.

Main Methods:

• Cross-sectional survey utilizing clinical vignettes to assess surgeon likelihood of employing PCDM strategies.
• Repeated-measures mixed-effects linear regression analysis to evaluate approaches to PCDM.
• Data analysis included adjusted estimates as least-squares mean (LSM) values.

Main Results:

• Surgeons at academic hospitals were less likely to be directive, spend equal time discussing options, or make explicit recommendations compared to nonacademic counterparts.
• Breast cancer specialists, surgeons with 10+ years of experience, and female surgeons were more likely to discuss all treatment options.
• Surgeons perceived blue-collar patients as less inclined towards active participation in decision-making than white-collar patients.

Conclusions:

• Surgeon approaches to PCDM are influenced by a variety of surgeon and patient characteristics.
• Further research is necessary to understand how PCDM strategies can be effectively tailored to specific clinical contexts and diverse patient needs.