Document Detail


Shared Decision-making in Orthopaedic Surgery.
MedLine Citation:
PMID:  22057819     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The process of clinical decision-making and the patient-physician relationship continue to evolve. Increasing patient involvement in clinical decision-making is embodied in the concept of "shared decision-making" (SDM), in which the patient and physician share responsibility in the clinical decision-making process. Various patients' decision aid tools have been developed to enhance this process. QUESTIONS/PURPOSES: We therefore (1) describe decision-making models; (2) discuss the different types of patients' decision aids available to practice SDM; and (3) describe the practice and early impact of SDM on clinical orthopaedic surgery. METHODS: We performed a search of the literature using PubMed/MEDLINE and Cochrane Library. We identified studies related to shared decision-making and the use of patients' decision aids in orthopaedics. The search resulted in 113 titles, of which 21 were included with seven studies on patients' decision aid use specifically in orthopaedics. RESULTS: Although limited studies suggest the use of patients' decision aids may enhance decision-making, conclusions about the use of these aids in orthopaedic clinical practice cannot be made and further research examining the best type, timing, and content of patients' decision aids that will lead to maximum patient involvement and knowledge gains with minimal clinical workflow interruption are needed. CONCLUSION: In clinical practice today, patients are increasingly involved in clinical decision-making. Further research on SDM in orthopaedic surgery examining the feasibility and impact on practice, on patients' willingness and ability to actively participate in shared decision-making, and the timing and type of patients' decision aids appropriate for use is still needed.
Authors:
James Slover; Jennifer Shue; Karl Koenig
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-5
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  1528-1132     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1616, New York, NY, 10003, USA, James.Slover@nyumc.org.
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