Preference Sensitive Care and Shared Decision-Making in Lumbar Spinal Stenosis: A Scoping Review

Area of Science:

• Spinal Surgery
• Health Services Research
• Patient-Centered Care

Background:

• Lumbar spinal stenosis (LSS) presents preference-sensitive care scenarios with multiple treatment options and trade-offs.
• Preference-sensitive care emphasizes patient values and preferences in clinical decision-making.
• Understanding patient preferences is crucial for optimizing LSS treatment outcomes.

Purpose of the Study:

• To conduct a scoping review on preference sensitivity in LSS treatment decisions.
• To explore the utilization of shared decision-making (SDM) as a proxy for preference sensitivity in LSS research.
• To identify research gaps regarding patient preferences and decision aids in LSS.

Main Methods:

• Scoping review conducted following PRISMA-ScR guidelines.
• Protocol registered on Open Science Framework (ID: 9ewup).
• Systematic search of multiple databases from January 2000 to October 2022, with independent review by three researchers.

Main Results:

• Included 16 studies published between 2016-2021, examining SDM, patient/surgeon preferences, and decision aids (DAs).
• SDM influenced treatment choice and patient satisfaction, but its impact on patient understanding was less clear.
• DAs were utilized in some studies to facilitate SDM in LSS treatment decisions.

Conclusions:

• A significant gap exists in comprehensive studies on LSS treatment preference sensitivity and the role of DAs.
• Further research is essential to elucidate the impact of patient preferences and the effectiveness of DAs in LSS care.
• This review establishes a foundation for future research in preference-sensitive care and SDM for LSS.