Shared decision-making is a combination of expertise, available scientific evidence, and the preferences of the patient and surgeon. In order to help patients navigate a path to the most appropriate decision, clinicians should understand the individual’s values, what matters most to them, and their comfort with uncertainty and risk. Misperceptions about symptoms and diseases are common. Clinicians can help by identifying misconceptions and gently correcting them.

Some surgeons contend that patients are less capable of participating in decisions about traumatic conditions compared to nontraumatic conditions. However, it was recently found that there is no difference in decision-making preferences between patients with traumatic and nontraumatic conditions (1). People prefer to be involved in decision-making whether or not the condition is time-sensitive, such as an injury.

Another notable finding is that more educated patients prefer a more active role in decision-making (1). Clinicians should be motivated to share their expertise about the treatment options, potential outcomes, benefits, and harms with every patient while listening to their preferences and concerns, resulting in a value-based shared decision. As modern computing becomes more widespread in healthcare, sophisticated methods of processing and personalizing patient information may play a more important role in clinical care and treatment decisions.

Our research on decision preferences is focusing on several areas:

1. We are qualitatively studying the facilitators and barriers regarding seeking a second opinion from surgeons.
2. We are conducting a poll about the ethics of clinicians knowingly using or benefiting from the placebo effect.
3. We are observing trends in decision-making preferences between surgeons and patients with carpal tunnel syndrome.

References

1. Hageman MG, Reddy R, Makarawung DJ, Briet JP, van Dijk CN, Ring D. Do Upper Extremity Trauma Patients Have Different Preferences for Shared Decision-making Than Patients With Nontraumatic Conditions? Clin Orthop Relat Res. 2015 Nov;473(11):3542-8. doi: 10.1007/s11999-015-4375-x. PubMed PMID: 26040968; PubMed Central PMCID: PMC4586205.