Perceived vs Actual Shared Decision-Making Behavior Among Urologists: A Convergent, Parallel, Mixed-Methods Study of Self-Reported Practice - 31/12/23
, Katy Reines c, g, William D. Meeks d, g, Rachel Mbassa d, g, Chad Ellimoottil a, g, Anna Faris a, g, Daniel S. Reuland e, g, Matthew E. Nielsen c, g, Randall Teal f, g, Maihan Vu f, g, J. Quentin Clemens a, g, Hung-Jui Tan c, gRésumé |
Objective |
To evaluate the association between self-perceived use of shared decision-making among urologists with use of validated prediction tools and self-described surgical decision-making.
Methods |
This is a convergent mixed methods study of these parallel data from two modules (Shared Decision Making and Validated Prediction tools) within the 2019 American Urological Association (AUA) Annual Census. The shared decision-making (SDM) module queried aspects of SDM that urologists regularly used. The validated prediction tools module queried whether urologists regularly used, trusted, and found prediction tools helpful. Selected respondents to the 2019 AUA Annual Census underwent qualitative interviews on their surgical decision-making.
Results |
In the weight sampled of 12,312 practicing urologists, most (77%) reported routine use of SDM, whereas only 30% noted regular use of validated prediction tools. On multivariable analysis, users of prediction tools were not associated with regular SDM use (31% vs 28%, P = .006) though was associated with use of decision aids f (32% vs 26%, P < .001). Shared decision-making emerged thematically with respect to matching treatment options, prioritizing goals, and navigating challenging decisions. However, the six specific components of shared decision-making ranged in their mentions within qualitative interviews.
Conclusion |
Most urologists report performing SDM as supported by its thematic presence in surgical decision-making. However, only a minority use validated prediction tools and urologists infrequently mention specific SDM components. This discrepancy provides an opportunity to explore how urologists perform SDM and can be used to support integrated strategies to implement SDM more effectively in clinical practice.
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| Funding Support: Giulia I. Lane, MD was supported by a T32 NIDDK Grant T32DK007782; F32 NIDDK Grant F32DK126232 and by K-12 K12-DK111011-06 UroEPI Career Development Program at the University of Michigan Department of Urology Hung-Jui Tan, MD, MSHPM was supported by a Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-18-193-01-CPPB, from the American Cancer Society as well as the NIH Loan Repayment Program. The qualitative interviews were conducted through the UNC Connected Health for Applications & Interventions (CHAI) Core, which receives funding support from National Institutes of Health grant DK056350. |
Vol 183
P. 78-84 - janvier 2024 Retour au numéro
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