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Shared decision-making in head and neck surgery is crucial for incorporating patient values with medical evidence. However, research and clinical focus on this approach remain limited, highlighting a significant need for development.

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Area of Science:

  • Otolaryngology-Head and Neck Surgery
  • Oncology
  • Health Services Research

Background:

  • Shared decision-making (SDM) is a physician-patient partnership integrating patient values and preferences with medical evidence.
  • SDM can reduce decisional conflict, enhance value-choice congruence, and increase patient involvement in care.
  • Head and neck surgical oncology frequently involves preference-sensitive decisions, making SDM particularly relevant.

Purpose of the Study:

  • To review the current state of shared decision-making in otolaryngology-head and neck surgery.
  • To identify gaps in research and clinical application of SDM within this specialty.
  • To emphasize the need for increased focus on SDM in head and neck cancer care.

Main Methods:

  • Literature review of conceptual models and measurement instruments for SDM.
  • Analysis of clinical scenarios in head and neck surgery where SDM is applicable (e.g., indeterminate thyroid nodules, laryngeal cancer, oral cancer).
  • Examination of existing patient decision aids relevant to head and neck surgery.

Main Results:

  • While over 40 instruments exist to measure SDM, few studies in head and neck surgery have explicitly used them.
  • Situations of clinical equipoise and potential value-option incongruence are common in head and neck oncology.
  • Patient decision aids have been developed for specific scenarios like laryngectomy or chemoradiotherapy.

Conclusions:

  • There is a significant lack of research and clinical application of shared decision-making in head and neck surgery.
  • Shared decision-making represents an area of substantial need within the specialty.
  • Additional efforts are required to implement and study SDM in head and neck surgical oncology.