BACKGROUND The interest in shared decision making has increased considerably over the last couple of decades.Decision aids(DAs)can help in shared decision making.Especially when there is more than one reasonable optio...BACKGROUND The interest in shared decision making has increased considerably over the last couple of decades.Decision aids(DAs)can help in shared decision making.Especially when there is more than one reasonable option and outcomes between treatments are comparable.AIM To investigate if the use of DAs decreases decisional conflict in patients when choosing treatment for knee or hip osteoarthritis(OA).METHODS In this multi-center unblinded randomized controlled trial of patients with knee or hip OA were included from four secondary and tertiary referral centers.Onehundred-thirty-one patients who consulted an orthopedic surgeon for the first time with knee or hip OA were included between December 2014 and January 2016.After the first consultation,patients were randomly assigned by a computer to the control group which was treated according to standard care,or to the intervention group which was treated with standard care and provided with a DA.After the first consultation,patients were asked to complete questionnaires about decisional conflict(DCS),satisfaction,anxiety(PASS-20),gained knowledge,stage of decision making and preferred treatment.Follow-up was carried out after 26 wk and evaluated decisional conflict,satisfaction,anxiety,health outcomes(HOOS/KOOS),quality of life(EQ5D)and chosen treatment.RESULTS After the first consultation,patients in the intervention group(mean DCS:25 out of 100,SD:13)had significantly(P value:0.00)less decisional conflict compared to patients in the control group(mean DCS:39 out of 100,SD 11).The mean satisfaction score for the given information(7.6 out of 10,SD:1.8 vs 8.6 out of 10,SD:1.1)(P value:0.00),mean satisfaction score with the physician(8.3 out of 10,SD:1.7 vs 8.9 out of 10,SD:0.9)(P value:0.01)and the mean knowledge score(3.3 out of 4,SD:0.9 vs 3.7 out of,SD:0.6)(P value:0.01)were all significantly higher in the intervention group.At 26-wk follow-up,only 75 of 131 patients(57%)were available for analysis.This sample is too small for meaningful analysis.CONCLUSION Providing patients with an additional DA may have a positive effect on decisional conflict after the first consultation.Due to loss to follow-up we are unsure if this effect remains over time.展开更多
Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The pat...Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction.展开更多
目的:从文献计量学角度对国内外有关决策冲突(DC)的研究现状、热点和趋势进行可视化分析。方法:检索Web of Science(WOS)核心合集和中国知网(CNKI)相关文献记录,通过CiteSpace 6.3.R1对作者、国家、机构和关键词等内容进行可视化分析。...目的:从文献计量学角度对国内外有关决策冲突(DC)的研究现状、热点和趋势进行可视化分析。方法:检索Web of Science(WOS)核心合集和中国知网(CNKI)相关文献记录,通过CiteSpace 6.3.R1对作者、国家、机构和关键词等内容进行可视化分析。结果:共纳入中文文献112篇、英文文献1271篇;发文量整体呈锯齿状增长趋势;研究热点集中在预立医疗照护计划(ACP)、决策辅助工具、共享决策(SDM)、癌症、决策制定、随机对照试验等。结论:我国DC研究仍处于发展阶段,未来应继续重视开发多样化的DC支持措施,减少DC,提高决策质量,进而推进ACP和SDM在治疗决策过程中的重要作用。展开更多
This paper gives a few of classes of fundamental concepts that describe dynamic conflictdecision analysis and selection and applies dynamic conflict decision analysis in stock investment andbusiness.
目的:评价医患共享决策模式在糖尿病患者中的应用效果。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库中关于医患共享决策模式在糖尿病患者中应...目的:评价医患共享决策模式在糖尿病患者中的应用效果。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库中关于医患共享决策模式在糖尿病患者中应用的随机对照试验,检索时限均为2011年7月2日至2021年7月2日。由2名研究员独立筛选文献、评价质量和提取资料,并采用RevMan 5.3进行Meta分析。结果:共纳入14篇文献,包括2325例糖尿病患者。Meta分析结果显示,医患共享决策模式干预可缓解糖尿病患者决策困境(P=0.0007),提高其决策自我效能(P=0.0002)和用药依从性(P=0.03),并降低其体质量指数(BMI)(P=0.01),在改善糖化血红蛋白值(glycosylated hemoglobin,HbA1c)方面,短期(3个月)内能降低其HbA1c值(P=0.001),但长期(6个月、24个月)的效果未表现出明显优势(P=0.23、P=0.27)。结论:医患共享决策模式干预有助于改善糖尿病患者的决策质量,提高其用药依从性和降低其BMI值,并在短期(3个月)内降低其HbA1c值。建议未来在临床糖尿病领域继续开展医患共享决策模式相关干预研究,以进一步验证其有效性。展开更多
文摘BACKGROUND The interest in shared decision making has increased considerably over the last couple of decades.Decision aids(DAs)can help in shared decision making.Especially when there is more than one reasonable option and outcomes between treatments are comparable.AIM To investigate if the use of DAs decreases decisional conflict in patients when choosing treatment for knee or hip osteoarthritis(OA).METHODS In this multi-center unblinded randomized controlled trial of patients with knee or hip OA were included from four secondary and tertiary referral centers.Onehundred-thirty-one patients who consulted an orthopedic surgeon for the first time with knee or hip OA were included between December 2014 and January 2016.After the first consultation,patients were randomly assigned by a computer to the control group which was treated according to standard care,or to the intervention group which was treated with standard care and provided with a DA.After the first consultation,patients were asked to complete questionnaires about decisional conflict(DCS),satisfaction,anxiety(PASS-20),gained knowledge,stage of decision making and preferred treatment.Follow-up was carried out after 26 wk and evaluated decisional conflict,satisfaction,anxiety,health outcomes(HOOS/KOOS),quality of life(EQ5D)and chosen treatment.RESULTS After the first consultation,patients in the intervention group(mean DCS:25 out of 100,SD:13)had significantly(P value:0.00)less decisional conflict compared to patients in the control group(mean DCS:39 out of 100,SD 11).The mean satisfaction score for the given information(7.6 out of 10,SD:1.8 vs 8.6 out of 10,SD:1.1)(P value:0.00),mean satisfaction score with the physician(8.3 out of 10,SD:1.7 vs 8.9 out of 10,SD:0.9)(P value:0.01)and the mean knowledge score(3.3 out of 4,SD:0.9 vs 3.7 out of,SD:0.6)(P value:0.01)were all significantly higher in the intervention group.At 26-wk follow-up,only 75 of 131 patients(57%)were available for analysis.This sample is too small for meaningful analysis.CONCLUSION Providing patients with an additional DA may have a positive effect on decisional conflict after the first consultation.Due to loss to follow-up we are unsure if this effect remains over time.
文摘Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction.
文摘目的:从文献计量学角度对国内外有关决策冲突(DC)的研究现状、热点和趋势进行可视化分析。方法:检索Web of Science(WOS)核心合集和中国知网(CNKI)相关文献记录,通过CiteSpace 6.3.R1对作者、国家、机构和关键词等内容进行可视化分析。结果:共纳入中文文献112篇、英文文献1271篇;发文量整体呈锯齿状增长趋势;研究热点集中在预立医疗照护计划(ACP)、决策辅助工具、共享决策(SDM)、癌症、决策制定、随机对照试验等。结论:我国DC研究仍处于发展阶段,未来应继续重视开发多样化的DC支持措施,减少DC,提高决策质量,进而推进ACP和SDM在治疗决策过程中的重要作用。
文摘This paper gives a few of classes of fundamental concepts that describe dynamic conflictdecision analysis and selection and applies dynamic conflict decision analysis in stock investment andbusiness.
