Shared decision making: Does a physician's decision‐making style affect patient participation in treatment choices for primary immunodeficiency?

Abstract

Overall health care spending in the United States is equivalent to more than 15% of GDP, yet outcomes rank below the top 25 in most quality categories when compared with other Organization for Economic Cooperation and Development (OECD) countries. The majority of spending is consumed by small patient populations with chronic diseases. Experts believe increased patient‐physician shared decision making (SDM) should result in better overall longitudinal care but understanding the physician's role in facilitating SDM is limited. Structural equation modelling was applied to results of a 2016 questionnaire‐based survey of 330 US physicians who treat approximately 55% of primary immune deficiency requiring immune globulin therapy; it tested the relationship between slow/rational vs fast/intuitive decision‐making styles and SDM as mediated by patient‐centric care and moderated by physician's trust in the patient. The results showed a statistically significant relationship between slow/rational decision making and SDM. The results also suggest differences related to age, gender, education, and race but no differences related to trust.

Shared Decision Making and Choice for Bariatric Surgery

“…Today, bariatric surgery is considered an effective strategy to maintain the weight loss effect, significantly improve obesity-related comorbidities, reduce obesity mortality, and improve the quality of life of patients; moreover, bariatric surgery has also been proven to be cost-effective [46]. While it is easy to say that patients should be allowed to make decisions themselves, practical implementation of this is difficult [47].…”

Towards a Reference Architecture for Female-Sensitive Drug Management

“…To deliver ground for a justified discussion to yield shared decision-making for medical treatment (e.g., [49]), the artifact has to provide a condensed account of the input data (E4). This information has to be shared with the patient to trigger shared decision-making and the healthcare professionals as a common ground for discussion [10] (E5).…”

“…However, they require different degrees of information. While healthcare professionals need detailed explanation and reasoning, for example, about drug interactions, patients may rather be interested in whether and how their preferences can be mapped to their treatment (e.g., [49]). Hence, the artifact must display information with varying perspectives and degrees of detail per stakeholder (E6).…”

Interactions between persons—Knowledge, decision making, and the co‐production of practice

“…Christopher Lamb et al produced a path model of how physician decision‐making style is associated with patient decision making around treatment choice for primary immunodeficiency (PID), which is rare but expensive to treat. The model was developed by applying structural equation analysis to cross‐sectional findings from 330 web‐based surveys.…”

“…It includes papers on the nature of reasoning and evidence, the on‐going problems of how to “integrate” different forms of scientific knowledge with each other, and with broader, humanistic understandings of reasoning and judgement, patient and community perspectives . Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under‐developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on SDM, analysing its proper meaning, its role in policy, methods for realizing it and its limitations in real‐world contexts …”