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Related Experiment Video

Updated: Oct 29, 2025

Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
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A Preference-Sensitive Online Instrument to Support Shared Decision Making for Patients With Pelvic Organ Prolapse: A

Mette Hulbaek1, Jette Primdahl, Regner Birkelund

  • 1Author Affiliations: Department of Gynecology and Obstetrics, Hospital of Southern Jutland (Dr Hulbaek), University Hospital of Southern Denmark, Aabenraa; Department of Regional Health Research (Drs Hulbaek, Primdahl, and Birkelund), University of Southern Denmark, Odense; Open Patient data Explorative Network (Dr Hulbaek), OPEN, Odense University Hospital; Danish Hospital for Rheumatic Diseases (Dr Primdahl), University Hospital of Southern Denmark, Soenderborg; Hospital of Southern Jutland (Dr Primdahl), University Hospital of Southern Denmark, Aabenraa; Lillebaelt Hospital (Dr Birkelund), University Hospital of Southern Denmark, Vejle; Department of Gynecology and Obstetrics, Lillebaelt Hospital (Dr Dr Al-kozai), University Hospital of Southern Denmark, Kolding; Department of Gynecology and Obstetrics (Dr Barawi), University Hospital of Southern Denmark, Aabenraa; Department of Gynecology and Obstetrics (Dr Ebbesen), Odense University Hospital; Research Unit for General Practice, Department of Public Health (Dr Nielsen), University of Southern Denmark, Odense; and OPEN Odense Patient data Explorative Network (Dr Hulbaek), Odense University Hospital, and the Region of Southern Denmark.

Computers, Informatics, Nursing : CIN
|July 9, 2021
PubMed
Summary

A new instrument to aid shared decision-making for pelvic organ prolapse was tested. While women found it supportive, low recruitment and inconsistent use by doctors highlight challenges for future trials.

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Area of Science:

  • Urogynecology
  • Shared Decision-Making
  • Clinical Trial Feasibility

Background:

  • Pelvic organ prolapse (POP) management requires patient involvement in treatment choices.
  • A preference-sensitive instrument was developed to enhance shared decision-making (SDM) in POP.
  • Assessing the feasibility of a randomized controlled trial (RCT) is crucial for evaluating the instrument's effectiveness.

Purpose of the Study:

  • To evaluate the feasibility of conducting a pilot RCT for a POP SDM instrument.
  • To assess recruitment rates, adherence to protocol, and patient/clinician perceptions.
  • To identify barriers and facilitators for implementing the instrument in clinical practice.

Main Methods:

  • A pilot RCT was conducted across three Danish gynecological clinics.
  • Feasibility was assessed via recruitment percentages, per-protocol use, and patient-reported outcomes (SDM Questionnaire, decision satisfaction).
  • Gynecologist perspectives were gathered through a focus group interview.

Main Results:

  • Recruitment rate was low (20%), with online mailbox delivery issues cited as a primary barrier.
  • The Shared Decision-Making Questionnaire demonstrated high completeness (96%) but a potential ceiling effect.
  • Women perceived the instrument as supportive of decision-making, especially when used interactively; however, gynecologists showed inconsistent adherence to protocol (41%).

Conclusions:

  • Current recruitment strategies require revision for future large-scale RCTs.
  • Gynecologist training and standardized implementation protocols are necessary for effective instrument use.
  • Future RCTs should consider alternative recruitment methods (e.g., nurse-led preconsultations) and cluster randomization to mitigate bias.