<p>Patient Preferences as Guidance for Information Framing in a Medical Shared Decision-Making Approach: The Bridge Between Nudging and Patient Preferences</p>

Abstract

Guidelines and policies support the decision process to make sure that patients can benefit from the best treatment for their condition. The implementation of guidelines and policies is evolving, allowing decision makers to be able to choose between alternatives while considering the effect of biases and fallacies that may hinder their choice. Patient preferences play a precious role in those decisions in which is not possible to recognize an objective “best” alternative and it’s not possible to nudge them toward one alternative based on scientific evidence and clinical experience. Having patient input as part of the decision process itself would allow the recognition of the attributes related to what is relevant for patients, which can be considered as important as clinical data. The authors advocate that the integration of preference-sensitive attributes with decision policies could provide a benefit against fallacies in the decision process when there is not a “best” alternative, and a shared decision-making paradigm allows both patient and clinician to recognize and pursue the option that best fits the individual case.

COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study

“…However, in the absence of clear data, the inte gration of patients' preferences could provide a benefit, especially in decisions in which uncer tainty is high. 26 In this perspective, a shared decision-making paradigm will allow both patients and clinicians to recognise and pursue the option that best fits the individual.…”

Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

“…The patient’s will to be involved in therapeutic decisions should be investigated. If positive, a shared decision-making process should be structured by integrating patients’ and clinicians’ values and beliefs to recognize the “best” outcome for each specific scenario, ultimately improving patients’ outcomes [ 50 ].…”

Image-Guided Thermal Ablation as an Alternative to Surgery for Papillary Thyroid Microcarcinoma: Preliminary Results of an Italian Experience

“…Assessing patient's perceptions and preferences for available treatments is becoming every day more important in decision making in oncology. Specifically, in recent years, there has been a shift toward a more patient-centered care and a growing emphasis on the relevance of involving patients in the clinical decision-making (50)(51)(52)(53), as well in the evaluation of competing treatment options or health interventions (54,55). For example, as highlighted by the P5 medicine approach (56,57), each patient has a peculiar set of psychological and cognitive factors, such as preferences and needs and, as well as hopes, fear, beliefs and cognitive dispositions.…”