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Perceived vs Actual Shared Decision-Making Behavior Among Urologists: A Convergent, Parallel, Mixed-Methods Study of
Giulia M Ippolito1, Katy Reines2, William D Meeks3
1Department of Urology, University of Michigan, Ann Arbor, MI; Ann Arbor VA Medical Center, Ann Arbor, MI.
Urology
|November 23, 2023
Summary
Most urologists use shared decision-making (SDM), but few utilize validated prediction tools. This highlights an opportunity to enhance SDM implementation in urological surgical decision-making.
Area of Science:
- Urology
- Health Services Research
- Medical Decision Making
Background:
- Shared decision-making (SDM) is crucial in clinical practice.
- The integration of validated prediction tools into SDM is an evolving area.
- Understanding current urologist practices is essential for improving patient care.
Purpose of the Study:
- To assess the association between urologists' self-perceived use of SDM and their utilization of validated prediction tools.
- To explore how urologists describe their surgical decision-making processes.
Main Methods:
- Convergent mixed-methods study using data from the 2019 American Urological Association (AUA) Annual Census.
- Quantitative data collected via SDM and validated prediction tool modules.
- Qualitative interviews conducted with selected AUA census respondents.
Main Results:
- 77% of urologists reported routine SDM use, while only 30% regularly used validated prediction tools.
- Prediction tool use was not significantly associated with regular SDM use (31% vs 28%, P=.006).
- Prediction tool users were more likely to use decision aids (32% vs 26%, P<.001).
Conclusions:
- While most urologists practice SDM, a minority use validated prediction tools.
- Specific components of SDM were infrequently mentioned in qualitative interviews.
- There is a need for integrated strategies to enhance SDM implementation in urology.
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