Dataset Information

Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation-an observational study.

ABSTRACT:

Purpose

To characterize the feedback of patients with thyroid nodules receiving care using a shared decision making (SDM) tool designed to improve conversations with their clinicians related to diagnostic options (e.g. thyroid biopsy, ultrasound surveillance).

Methods

Investigators qualitatively analyzed post-encounter interviews with patients to characterize their feedback of a SDM tool used during their clinical visits. Additionally, investigators counted instances of diagnostic choice awareness and of patients' expression of a diagnostic management preference in recordings of clinical encounters of adult patients presenting for evaluation of thyroid nodules in which the SDM tool was used.

Results

In total, 53 patients (42 (79%) women); median age 62 years were enrolled and had consultations supported by the SDM tool. Patients were favorable about the design of the SDM tool and its ability to convey information about options and support patient-clinician interactions. Patients identified opportunities to improve the tool through adding more content and improve its use in practice through training of clinicians in its use. There was evidence of diagnostic choice awareness in 52 (98%) of these visits and patients expressed a diagnostic management preference in 40 (76%).

Conclusion

User centered design including feedback from patients and real life observation supports the use of the SDM tool to facilitate collaboration between patients and clinicians.

SUBMITTER: Patel Chavez CP

PROVIDER: S-EPMC10292116 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation-an observational study.

Patel Chavez Chandani Patel CP Godinez Leiva Eddison E Bagautdinova Diliara D Hidalgo Jessica J Hartasanchez Sandra S Barb Diana D Danan Deepa D Dziegielewski Peter P Edwards Catherine C Hughley Brian B Srihari Ashok A Subbarayan Sreevidya S Castro M Regina MR Dean Diana D Morris John J Ryder Mabel M Stan Marius N MN Hargraves Ian I Shepel Kathryn K Brito Juan P JP Bylund Carma L CL Treise Debbie D Montori Victor V Singh Ospina Naykky N

Endocrine 20221219 1

<h4>Purpose</h4>To characterize the feedback of patients with thyroid nodules receiving care using a shared decision making (SDM) tool designed to improve conversations with their clinicians related to diagnostic options (e.g. thyroid biopsy, ultrasound surveillance).<h4>Methods</h4>Investigators qualitatively analyzed post-encounter interviews with patients to characterize their feedback of a SDM tool used during their clinical visits. Additionally, investigators counted instances of diagnostic ...[more]

PMID: 36534326

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Project description:ObjectivePatient values and preferences are an important component to decision making when tradeoffs exist that impact quality of life, such as tradeoffs between stroke prevention and hemorrhage in patients with atrial fibrillation (AF) contemplating anticoagulant therapy. Our objective is to describe the development of an Atrial Fibrillation Guideline Support Tool (AFGuST) to assist the process of integrating patients' preferences into this decision.Materials and methodsCHA2DS2VASc and HAS-BLED were used to calculate risks for stroke and hemorrhage. We developed a Markov decision analytic model as a computational engine to integrate patient-specific risk for stroke and hemorrhage and individual patient values for relevant outcomes in decisions about anticoagulant therapy.ResultsIndividual patient preferences for health-related outcomes may have greater or lesser impact on the choice of optimal antithrombotic therapy, depending upon the balance of patient-specific risks for ischemic stroke and major bleeding. These factors have been incorporated into patient-tailored booklets which, along with an informational video, were developed through an iterative process with clinicians and patient focus groups.Key limitationsCurrent risk prediction models for hemorrhage, such as the HAS-BLED, used in the AFGuST, do not incorporate all potentially significant risk factors. Novel oral anticoagulant agents recently approved for use in the United States, Canada, and Europe have not been included in the AFGuST. Rather, warfarin has been used as a conservative proxy for all oral anticoagulant therapy.ConclusionsWe present a proof of concept that a patient-tailored decision-support tool could bridge the gap between guidelines and practice by incorporating individual patient's stroke and bleeding risks and their values for major bleeding events and stroke to facilitate a shared decision making process. If effective, the AFGuST could be used as an adjunct to published guidelines to enhance patient-centered conversations about the anticoagulation management.

Dataset Information

Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation-an observational study.

Purpose

Methods

Results

Conclusion

Publications

Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation-an observational study.

Similar Datasets

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