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Toma de decisiones compartida en diagnóstico: directrices prácticas
Sofie Jacobse1,2, Hanneke Rijkels-Otters3, Laura Zwaan4
1Erasmus MC, Rotterdam. Afd. Huisartsgeneeskunde en Institute of Medical Education Research Rotterdam (iMERR).
Nederlands tijdschrift voor geneeskunde
|February 20, 2026
Resumen
La toma de decisiones compartida (TDC) mejora los procesos diagnósticos al integrar los valores del paciente con la experiencia clínica. La aplicación de la TDC al diagnóstico, particularmente en áreas de incertidumbre y riesgo, puede mejorar la atención centrada en el paciente y reducir el daño.
Área de la Ciencia:
- Ética médica
- Práctica general
- Seguridad del paciente
Sus antecedentes:
- La toma de decisiones compartida (TDC) está establecida en el tratamiento y el cribado, pero infrautilizada en el diagnóstico.
- La toma de decisiones diagnósticas implica desafíos únicos como la incertidumbre y la evidencia cambiante.
Objetivo del estudio:
- Identificar áreas clave dentro del proceso diagnóstico donde la TDC puede agregar valor.
- Explorar la relevancia de la TDC en la toma de decisiones diagnósticas en la práctica general.
Principales métodos:
- Análisis de 90 reclamaciones por mala praxis anonimizadas relacionadas con decisiones diagnósticas en la práctica general.
- Identificación de temas donde las perspectivas del paciente y del médico divergieron.
Principales resultados:
- Seis temas emergieron donde la TDC podría agregar valor: evaluación de riesgos, tiempo como herramienta diagnóstica, consecuencias de las pruebas, ejecución práctica, reevaluación del diagnóstico y contexto individual.
- Se identificaron perspectivas divergentes entre médicos y pacientes en estos temas.
Conclusiones:
- La integración de la TDC en la práctica diagnóstica puede mejorar la comprensión mutua y el enfoque centrado en el paciente.
- Abordar los temas identificados a través de la TDC puede prevenir retrasos y reducir el daño en el diagnóstico.
- La TDC debe considerarse un componente estructural de la atención diagnóstica.
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