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Development of a checklist for evaluation of shared decision-making in consultation for extremely preterm delivery

Michael Guindon1,2, Dalia M Feltman3, Carrie Litke-Wager4,5

  • 1Department of Pediatrics, Division of Neonatology, Brooke Army Medical Center, San Antonio, TX, USA. Michael.Guindon@usuhs.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|October 22, 2024
PubMed

Insights

A new checklist was developed to assess shared decision-making (SDM) during consultations for extremely preterm deliveries. While reliable overall, expert scorers showed moderate agreement, indicating potential for improving neonatal care discussions.

Area of Science:

  • Neonatal care
  • Medical ethics
  • Health communication

Background:

  • Shared decision-making (SDM) is crucial for parental consultations regarding extremely preterm delivery.
  • Effective SDM ensures optimal neonatal care planning.

Purpose of the Study:

  • To create and evaluate a literature-based checklist for assessing SDM practices.
  • To specifically examine SDM during consultations for extremely preterm delivery.

Main Methods:

  • Developed an SDM counseling behaviors checklist via literature review and expert consensus.
  • Assessed checklist reliability using mock consultations with standardized patients.
  • Analyzed inter-rater reliability (intraclass correlation coefficients) and internal consistency (Cronbach's alpha).

Main Results:

  • The checklist demonstrated moderate aggregate reliability among scorers.
  • Internal consistency was excellent (Cronbach's alpha = 0.93).
  • Agreement varied: moderate between expert scorers, poor between novice scorers.

Conclusions:

  • The novel SDM checklist shows promise for evaluating consultations in high-stakes obstetric scenarios.
  • Potential applications include future research, professional training, and clinical quality improvement.
  • Further validation may enhance its utility across different scorer expertise levels.
Abstract

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