Related Experiment Video
Updated: May 20, 2026
Operant Protocols for Assessing the Cost-benefit Analysis During Reinforced Decision Making by Rodents
Published on: September 10, 2018
Decision-Making in Refractory Overactive Bladder: Evaluation of a Novel Patient Decision Aid and its Impact on
Rayan Mohamed-Ahmed1, Angie Rantell2, Annika Taithongchai2
1Department of Urogynaecology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. r.mohamed-ahmed@nhs.net.
Background:
Refractory overactive bladder (OAB) lacks formal definition and is poorly understood. Its management requires patients to choose an invasive treatment, including intravesical botulinum toxin A (BOTOX®), sacral neuromodulation (SNM) and posterior tibial nerve stimulation (PTNS), which have varying rates of efficacy and side effects. These decisions can be complex for patients to make, especially within the time constraints of outpatient clinic appointments. A new patient decision aid (PDA) has been developed to support patients during this shared decision-making process.
Aim:
This study assesses decisional conflict scores and patient satisfaction in those who use a novel PDA for refractory OAB.
Methods:
Consecutive new patients with refractory OAB were provided with the PDA prior to decision-making. Patients then had a virtual follow-up appointment to assess their decisional conflict, using a validated scale. The total decisional conflict score was calculated. Treatment choice and free-text feedback were also analysed.
Results:
Twenty-five patients were included. Following use of the PDA, a range of treatment choices were made, including SNM (n = 6), PTNS (n = 10), BOTOX® (n = 6) and continuation with medical therapy (n = 3). Overall, decisional conflict was low, with 100% of patients having a score of less than 25. Subscores suggested improved patient understanding, with the PDA increasing clarification.
Conclusion:
Introduction of this novel PDA, in those requiring treatment for refractory OAB, was associated with low decisional conflict and positive patient feedback. This supports its use in shared decision-making, empowering patients to make an informed and individualised choice regarding their treatment.
Related Concept Videos
01:20Decision Making
Automatic decision-making is fast, intuitive, and relies on gut feelings...
01:14Frustration and Conflict: Avoidance-Avoidance, Double-Approach Avoidance
01:28Urinary Tract Calculi V: Nursing Management
01:14Decision Making: Traditional Method
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...
01:30Urinary Tract Calculi III: Medical Management
01:09Decision Making: P-value Method
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can have a...