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Using CollaboRATE to Characterize Surgeon-Level Shared Decision-Making Performance.

Anoosha Moturu1,2, Geoffrey Hobika2,3, Jason B Liu4,5

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Summary
This summary is machine-generated.

Shared decision-making (SDM) varies among surgeons, with many not achieving optimal patient-reported outcomes. Targeted training may improve this modifiable skill for better surgical care.

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Area of Science:

  • Surgical quality improvement
  • Patient-centered care

Background:

  • Shared decision-making (SDM) improves surgical outcomes by aligning care with patient values.
  • Assessing SDM variation among surgeons is crucial for quality improvement.

Purpose of the Study:

  • To characterize the variation in shared decision-making (SDM) levels among surgeons.
  • To identify factors associated with surgeon-level SDM performance using patient-reported data.

Main Methods:

  • Retrospective cohort study of 30,957 surgical patients and 2,921 surgeons (2020-2023).
  • Analysis of American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Patient-Reported Outcomes (PRO) data.
  • Multilevel logistic regression to identify factors associated with SDM performance.

Main Results:

  • 64% of patients reported adequate SDM (score of 27).
  • Only 1.2% of surgeons achieved optimal mean scores, while 80.6% met the median.
  • Lower performance linked to male gender, cardiothoracic specialty, rural practice, and >31 years of experience.

Conclusions:

  • CollaboRATE data reveals significant surgeon-level variability in SDM.
  • SDM appears to be a modifiable skill, suggesting a need for targeted surgeon training and quality improvement initiatives.