Development of a shared decision-making tool in vitiligo: an international study

Area of Science:

• Dermatology
• Medical Informatics
• Patient-Centered Care

Background:

• Shared decision-making tools (SDMTs) enhance patient-physician collaboration but are scarce in dermatology.
• Vitiligo management lacks specialized visual tools for joint decision-making.

Purpose of the Study:

• To develop and validate a novel SDMT for vitiligo patients undergoing specialized consultations.
• To improve therapeutic decision-making processes in vitiligo care.

Main Methods:

• A prospective, cross-sectional study incorporating qualitative interviews and an e-Delphi method.
• Developed the SDMT based on 91 identified topics from patient-clinician discussions.
• Validated the tool's usefulness, satisfaction, and readability through cognitive interviews and a multidisciplinary working group.

Main Results:

• Identified 91 key topics in vitiligo therapeutic decision-making, categorized into general goals and treatment-specific issues.
• Created an eight-card SDMT covering repigmentation, depigmentation, coping, stabilization, and disease information.
• Cognitive interviews confirmed the SDMT's satisfaction, readability, and usefulness.

Conclusions:

• A novel, validated SDMT for nonsegmental vitiligo was successfully developed.
• The tool was translated and cross-culturally validated for a US patient population, ensuring generalizability.
• This SDMT facilitates shared decision-making in vitiligo management.