Emily F. Boss|Nishchay Mehta|Neeraja Nagarajan|Anne R. Links|James R. Benke|Zackary Berger|Alexandra G. Espinel|Jeremy D. Meier|Ellen A. Lipstein
Shared Decision Making and Choice for Elective Surgical Care
Johns Hopkins Medicine|Johns Hopkins University|University College London|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Berman Institute of Bioethics|Johns Hopkins University|Children's National|Children's National|University of Utah
objective shared decision making sdm integrative patientprovider communication process emphasizing discussion scientific evidence patientfamily values may improve quality care delivery promote evidencebased practice reduce overuse surgical care little known however regarding sdm elective surgical practice purpose systematic review synthesize findings studies evaluating use outcomes sdm elective surgery data sources pubmed cochrane central embase cinahl scopus electronic databases review methods searched englishlanguage studies january 1 1990 august 9 2015 evaluating use sdm elective surgical care choice surgery could ascertained identified studies independently screened 2 reviewers stages titleabstract fulltext review abstracted data related population study design clinical dilemma use sdm outcomes treatment choice bias results 10929 identified articles 24 met inclusion criteria common area studied spine 7 24 followed joint 5 24 gynecologic surgery 4 24 twenty studies used decision aids support tools including modalities multimediavideo 13 20 written 3 20 personal coaching 4 20 effect sdm preference surgery mixed across studies showing decrease surgery 9 24 difference 8 24 increase 1 24 sdm tended improve decision quality 3 3 well knowledge preparation 4 6 decreasing decision conflict 4 6 conclusion sdm reduces decision conflict improves decision quality patients making choices elective surgery net findings show sdm may influence patients choose surgery less often impact sdm surgical utilization cannot clearly ascertained