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BMJ Open Dec 2019To (1) provide an up-to-date overview of shared decision making (SDM)-models, (2) give insight in the prominence of components present in SDM-models, (3) describe who is...
OBJECTIVES
To (1) provide an up-to-date overview of shared decision making (SDM)-models, (2) give insight in the prominence of components present in SDM-models, (3) describe who is identified as responsible within the components (patient, healthcare professional, both, none), (4) show the occurrence of SDM-components over time, and (5) present an SDM-map to identify SDM-components seen as key, per healthcare setting.
DESIGN
Systematic review.
ELIGIBILITY CRITERIA
Peer-reviewed articles in English presenting a new or adapted model of SDM.
INFORMATION SOURCES
Academic Search Premier, Cochrane, Embase, Emcare, PsycINFO, PubMed, and Web of Science were systematically searched for articles published up to and including September 2, 2019.
RESULTS
Forty articles were included, each describing a unique SDM-model. Twelve models were generic, the others were specific to a healthcare setting. Fourteen were based on empirical data, 26 primarily on analytical thinking. Fifty-three different elements were identified and clustered into 24 components. Overall was the most prominent component across models. Components present in >50% of models were: ), ), ), ), and (53%). In the majority of the models (27/40), both healthcare professional and patient were identified as actors. Over time, and are the two components which are present in most models in any time period. stood out for being present in a markedly larger proportion of models over time.
CONCLUSIONS
This review provides an up-to-date overview of SDM-models, showing that SDM-models quite consistently share some components but that a unified view on what SDM is, is still lacking. Clarity about what SDM constitutes is essential though for implementation, assessment, and research purposes. A map is offered to identify SDM-components seen as key.
TRIAL REGISTRATION
PROSPERO registration CRD42015019740.
Topics: Clinical Decision-Making; Decision Making; Humans; Models, Theoretical; Patient Preference
PubMed: 31852700
DOI: 10.1136/bmjopen-2019-031763 -
The Journal of Nursing Administration Mar 2017The purpose of this systematic review was to explore nurses' and physicians' perceptions of nurse-physician collaboration and the factors that influence their... (Review)
Review
The purpose of this systematic review was to explore nurses' and physicians' perceptions of nurse-physician collaboration and the factors that influence their perceptions. Overall, nurses and physicians held different perceptions of nurse-physician collaboration. Shared decision making, teamwork, and communication were reoccurring themes in reports of perceptions about nurse-physician collaboration. These findings have implications for more interprofessional educational courses and more intervention studies that focus on ways to improve nurse-physician collaboration.
Topics: Adult; Attitude of Health Personnel; Communication; Cooperative Behavior; Decision Making; Female; Humans; Male; Middle Aged; Nurses; Physician-Nurse Relations; Physicians
PubMed: 28157818
DOI: 10.1097/NNA.0000000000000460 -
Sports Medicine (Auckland, N.Z.) Apr 2019The aim of this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral...
OBJECTIVE
The aim of this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral ankle sprain (LAS) injury.
DESIGN
Systematic review and narrative synthesis.
DATA SOURCES
The PubMed (MEDLINE), Web of Science, PEDro, Cochrane Library, SPORTDiscus (EBSCO), ScienceDirect, and Scopus databases were searched to 23 November 2018.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies were included if they prospectively applied a criteria-based RTS decision-making process for patients with LAS injury, but were excluded if they merely gathered outcome measures at the RTS time point. Studies were also excluded if patients were recovering from ankle fracture, high ankle sprain, medial ankle sprain, chronic ankle instability or complex ankle injury.
RESULTS
No studies were identified that used a criteria-based RTS decision-making process for patients with LAS injury. We were unable to conduct a quantitative synthesis or meta-analysis, therefore we provide a narrative synthesis of relevant questionnaires, as well as clinical and functional assessments commonly used in studies retrieved in the search.
CONCLUSION
There are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury. Based on our narrative synthesis, we propose a number of variables that could be used to develop a criteria-based RTS decision paradigm. Future research should aim to reach consensus on these variables and apply them to actual RTS decisions within prospective study designs. Furthermore, we suggest that complex systems theory and the RTS continuum could be used to inform the development of an RTS decision-making paradigm for athletes with LAS injury.
Topics: Ankle Injuries; Decision Making; Evidence-Based Medicine; Exercise Test; Humans; Joint Instability; Return to Sport; Sprains and Strains; Surveys and Questionnaires
PubMed: 30747379
DOI: 10.1007/s40279-019-01071-3 -
Medicine Aug 2020Shared decision making (SDM) is a process within the physician-patient relationship applicable to any clinical action, whether diagnostic, therapeutic, or preventive in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Shared decision making (SDM) is a process within the physician-patient relationship applicable to any clinical action, whether diagnostic, therapeutic, or preventive in nature. It has been defined as a process of mutual respect and participation between the doctor and the patient. The aim of this study is to determine the effectiveness of decision aids (DA) in primary care based on changes in adherence to treatments, knowledge, and awareness of the disease, conflict with decisions, and patients' and health professionals' satisfaction with the intervention.
METHODS
A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in Medline, CINAHL, Embase, the Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database. The inclusion criteria were randomized clinical trials as study design; use of SDM with DA as an intervention; primary care as clinical context; written in English, Spanish, and Portuguese; and published between January 2007 and January 2019. The risk of bias of the included studies in this review was assessed according to the Cochrane Collaboration's tool.
RESULTS
Twenty four studies were selected out of the 201 references initially identified. With the use of DA, the use of antibiotics was reduced in cases of acute respiratory infection and decisional conflict was decreased when dealing with the treatment choice for atrial fibrillation and osteoporosis. The rate of determination of prostate-specific antigen (PSA) in the prostate cancer screening decreased and colorectal cancer screening increased. Both professionals and patients increased their knowledge about depression, type 2 diabetes, and the perception of risk of acute myocardial infarction at 10 years without statins and with statins. The satisfaction was greater with the use of DA in choosing the treatment for depression, in cardiovascular risk management, in the treatment of low back pain, and in the use of statin therapy in diabetes. Blinding of outcomes assessment was the most common bias.
CONCLUSIONS
DA used in primary care are effective to reduce decisional conflict and improve knowledge on the disease and treatment options, awareness of risk, and satisfaction with the decisions made. More studies are needed to assess the impact of shared decision making in primary care.
Topics: Decision Making, Shared; Decision Support Techniques; Humans; Primary Health Care
PubMed: 32769870
DOI: 10.1097/MD.0000000000021389 -
Vaccine Oct 2017Many parents make a conscious decision not to vaccinate their child. Multiple beliefs and perceptions surround this choice. If uptake of routine child vaccination is to... (Review)
Review
BACKGROUND
Many parents make a conscious decision not to vaccinate their child. Multiple beliefs and perceptions surround this choice. If uptake of routine child vaccination is to increase, public health communications about vaccines must be informed by evidence on the factors affecting uptake.
METHOD
We conducted a systematic review to investigate psychological, social and contextual factors associated with uptake of routine vaccines in young children. Studies were included if they reported analyses of the association between psychological factors and uptake or included parents' self-reported reasons for or against vaccination.
RESULTS
Our search identified 9110 citations after deduplication. Sixty-eight citations describing sixty-four studies were included in the review. The quality of the studies was mixed. There is strong evidence for an association between vaccination uptake and: not perceiving vaccines to cause adverse effects; general positive attitudes towards vaccination; positive vaccine recommendations; and perceiving fewer practical difficulties of vaccination. While there was good evidence for an association between vaccination and perceived susceptibility to the illness, evidence for an association between perceived severity of an illness and vaccination was weak. Other factors associated with vaccination include knowledge about the vaccine, social influences and trust in the healthcare profession. Having increased information about the vaccine was associated with vaccination, but the influence of different sources of information needs more research.
CONCLUSION
Understanding which factors are consistently associated with the decision to vaccinate one's child is important to identify messages which should be targeted by public health communications about routine child vaccinations.
Topics: Child; Decision Making; Health Knowledge, Attitudes, Practice; Humans; Parents; Vaccination; Vaccines
PubMed: 28974409
DOI: 10.1016/j.vaccine.2017.09.046 -
Seminars in Fetal & Neonatal Medicine Dec 2015Systematic reviews and meta-analyses are at the top of the 'evidence hierarchy' when assessing the effectiveness of health interventions. As such, they are important... (Review)
Review
Systematic reviews and meta-analyses are at the top of the 'evidence hierarchy' when assessing the effectiveness of health interventions. As such, they are important sources of synthesized information for decision-makers including consumers, clinicians, funders, payers, regulators, and researchers. The main reasons for undertaking systematic reviews and meta-analyses are to minimize bias and to maximize data by collating all the relevant, available evidence on a particular topic. In order to correctly inform decision-makers, but not mislead them, a number of key methodological conditions need to be met when undertaking these types of analysis. In this article we first review the history of systematic reviews and meta-analyses and then outline those conditions that may lead to the correct, or incorrect, use of these types of study. Also, new variations on standard systematic review methods are explored, with the pros and cons of each outlined.
Topics: Decision Making; Humans; Meta-Analysis as Topic; Review Literature as Topic
PubMed: 26515266
DOI: 10.1016/j.siny.2015.10.002 -
Neuroscience and Biobehavioral Reviews Dec 2021Impaired decision-making (DM) is well-known in suicidal behavior (SB). We aimed to review the evidence on DM and its mediating factors in SB and perform a meta-analysis... (Meta-Analysis)
Meta-Analysis Review
Impaired decision-making (DM) is well-known in suicidal behavior (SB). We aimed to review the evidence on DM and its mediating factors in SB and perform a meta-analysis on DM assessed using the Iowa Gambling Task (IGT). We conducted a search on databases of papers published on DM and SB up to 2020: 46 studies were included in the systematic review, and 18 in the meta-analysis. For meta-analysis, we compared DM performance between suicide attempters (SAs) and patients (PCs) or healthy controls (HCs). The systematic review showed that SAs have greater difficulties in all DM domains. The meta-analysis found worse IGT performance among SAs in comparison with PCs and HCs. A meta-regression did not find differences for age, gender, psychiatric disorder, and clinical status. Our findings indicate that SAs exhibited deficits in DM under conditions of risk though not ambiguity. Worse DM was independent of age, gender, psychiatric disorder, and suggested that DM impairment could be considered a cognitive trait of suicidal vulnerability, a risk factor and an attribute of SAs.
Topics: Decision Making; Gambling; Humans; Neuropsychological Tests; Suicidal Ideation; Suicide, Attempted
PubMed: 34619171
DOI: 10.1016/j.neubiorev.2021.10.005 -
Clinical Psychology Review Mar 2023Emotion-related impulsivity, the trait-like tendency toward regrettable behavior during states of high emotion, is a robust predictor of internalizing and externalizing... (Review)
Review
Emotion-related impulsivity, the trait-like tendency toward regrettable behavior during states of high emotion, is a robust predictor of internalizing and externalizing psychopathology. Despite substantial evidence that emotion-related impulsivity is important transdiagnostically, relatively little is known about its cognitive correlates. This systematic review and meta-regression investigates one such candidate, risky decision-making. We analyzed 195 effect sizes from 51 studies of 14,957 total participants, including 105 newly calculated effect sizes that were not reported in the original publications. The meta-regression demonstrated evidence for a small, positive relationship of emotion-related impulsivity with behavioral indices of risky decision-making (ß = 0.086). Effects generalized across sample age, gender, Positive versus Negative Urgency, and clinical versus nonclinical samples. The average effect size varied by task type, with stronger effects for the Iowa Gambling Task and Delay Discounting Task. Experimental arousal manipulation was nearly a significant moderator, with stress and pharmacological manipulations yielding significant effect sizes. Analyses indicated that publication bias did not skew the current findings. Notwithstanding limitations, the data suggest that risky decision-making is a cognitive domain that relates to emotion-related impulsivity. We conclude with recommendations regarding the specific types of tasks and arousal inductions that will best capture emotion-related impulsivity in future experimental research.
Topics: Humans; Impulsive Behavior; Gambling; Cognitive Dysfunction; Emotions; Decision Making
PubMed: 36512906
DOI: 10.1016/j.cpr.2022.102232 -
Academic Pediatrics 2015Little is known about the impact of interventions to support shared decision making (SDM) with pediatric patients. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Little is known about the impact of interventions to support shared decision making (SDM) with pediatric patients.
OBJECTIVES
To summarize the efficacy of SDM interventions in pediatrics on patient-centered outcomes.
DATA SOURCES
We searched Ovid Medline, Ovid Embase, Ovid Cochrane Library, Web of Science, Scopus, and Ovid PsycInfo from database inception to December 30, 2013, and performed an environmental scan.
STUDY ELIGIBILITY CRITERIA
We included interventions designed to engage pediatric patients, parents, or both in a medical decision, regardless of study design or reported outcomes.
STUDY APPRAISAL AND SYNTHESIS METHODS
We reviewed all studies in duplicate for inclusion, data extraction, and risk of bias assessment. Meta-analysis was performed on 3 outcomes: knowledge, decisional conflict, and satisfaction.
RESULTS
Sixty-one citations describing 54 interventions met eligibility criteria. Fifteen studies reported outcomes such that they were eligible for inclusion in meta-analysis. Heterogeneity across studies was high. Meta-analysis revealed SDM interventions significantly improved knowledge (standardized mean difference [SMD] 1.21, 95% confidence interval [CI] 0.26 to 2.17, P = .01) and reduced decisional conflict (SMD -1.20, 95% CI -2.01 to -0.40, P = .003). Interventions showed a nonsignificant trend toward increased satisfaction (SMD 0.37, 95% CI -0.04 to 0.78, P = .08).
LIMITATIONS
Included studies were heterogeneous in nature, including their conceptions of SDM.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
A limited evidence base suggests that pediatric SDM interventions improve knowledge and decisional conflict, but their impact on other outcomes is unclear.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42013004761 (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013004761).
Topics: Adolescent; Child; Child, Preschool; Decision Making; Decision Support Techniques; Humans; Infant; Infant, Newborn; Patient Participation; Pediatrics; Physician-Patient Relations; Professional-Family Relations
PubMed: 25983006
DOI: 10.1016/j.acap.2015.03.011 -
European Urology Focus May 2022Decision aids (DAs) aim to support patients in the process of shared decision-making for complex treatment decisions. To improve patient-centered care in uro-oncology,... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Decision aids (DAs) aim to support patients in the process of shared decision-making for complex treatment decisions. To improve patient-centered care in uro-oncology, it is essential to evaluate the availability and quality of existing DAs.
OBJECTIVE
To assess the quality of existing DAs for patients across the most prevalent uro-oncological entities.
EVIDENCE ACQUISITION
This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. A systematic literature search (MedLine, Cochrane Library, Web of Science Core Collection, and CCMed) was conducted to identify DAs for treatment decisions for patients with prostate, renal, or bladder cancer. All studies reporting on the development or evaluation of DAs were included. The DAs were examined based on the International Patient Decision Aid Standards (IPDAS) and the evaluation studies were compared in accordance with Standards for Universal reporting of a patient Decision Aid Evaluations (SUNDAE).
EVIDENCE SYNTHESIS
The literature search identified 1995 potentially relevant publications. Thirty-two studies reporting on 25 DAs met the inclusion criteria. Twenty-two DAs address prostate cancer, two renal tumor, and one bladder cancer. In the majority of DAs (n = 20), patients can enter individual data. A few (n = 6) DAs allow for personalization using a risk-adapted presentation of treatment options. The percentage of IPDAS criteria met in DAs ranged between 50% and 100% (median 87.5%), and the studies' adherence to the SUNDAE checklist was between 62% and 96% (median 86.6%). Evaluation studies suggest that interventions are likely efficacious. However, a preliminary meta-analysis revealed no significant difference between "DA" and "usual care" for decisional conflict or decisional regret.
CONCLUSIONS
This review highlights that a number of well-developed DAs exist in urology. However, there is a need for specific instruments targeting kidney and bladder cancer. Personalization of tools and adherence to international standards of DAs should be further improved.
PATIENT SUMMARY
The majority of uro-oncological decision aids target prostate cancer, whereas fewer address kidney or bladder cancer. The quality of the existing instruments is high, but can be increased further to better address specific needs of individual patients.
Topics: Decision Making, Shared; Decision Support Techniques; Humans; Male; Patient Participation; Prostatic Neoplasms; Urinary Bladder Neoplasms
PubMed: 33980474
DOI: 10.1016/j.euf.2021.04.013