Journal article
Do surgeons and patients/parents value shared decision-making in pediatric surgery? A systematic review
The Journal of surgical research, Vol.231, pp.49-53
11/2018
DOI: 10.1016/j.jss.2018.04.042
PMID: 30278968
Abstract
Shared decision-making (SDM) is touted as the preferred approach to clinical counseling. However, few data exist regarding whether patients prefer SDM over surgeon-guided discussions for complex surgical decision-making. Even fewer data exist regarding surgeon preferences. Such issues may be especially pronounced in pediatric surgery given the complex decision-making triad between patients/parents and surgeons. The objective of this systematic review was to evaluate patient/parent and surgeon attitudes toward SDM in pediatric surgery.
A systematic review of English language articles in Medline, EMBASE, and Cochrane databases was performed. Inclusion and exclusion criteria were predefined. Text screening and data abstraction were performed by two investigators.
Seven thousand five hundred eighty-four articles were screened. Title/abstract review excluded 7544 articles, and full-text review excluded four articles. Thirty-six articles were identified as addressing patient/parent or surgeon preferences toward SDM in pediatric surgery. Subspecialties included Otolaryngology (33%), General Surgery (30%), Plastics (14%), Cardiac (11%), Urology (8%), Neurosurgery (6%), Orthopedics (6%), and Gynecology (3%). Most studies (94%) evaluated elective/nonurgent procedures. The majority (97%) concentrated on patient/parent preferences, whereas only 22% addressed surgeon preferences. Eleven percent of studies found that surgeons favored SDM, and 73% demonstrated that patients/parents favored SDM.
Despite recommendations that SDM is the preferred approach to clinical counseling, our systematic literature review shows that few studies evaluate patient/parent and surgeon attitudes toward SDM in pediatric surgery. Of these studies, very few focus on complex, urgent/emergent decision-making. Further research is needed to understand whether patients/parents, as well as surgeons, may prefer a more surgeon-guided approach to decision-making, especially when surgery is complex or taking place in urgent/emergent settings.
Details
- Title: Subtitle
- Do surgeons and patients/parents value shared decision-making in pediatric surgery? A systematic review
- Creators
- Erica M Carlisle - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address: erica-carlisle@uiowa.eduLaura A Shinkunas - Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, IowaLauris C Kaldjian - Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of surgical research, Vol.231, pp.49-53
- DOI
- 10.1016/j.jss.2018.04.042
- PMID
- 30278968
- ISSN
- 0022-4804
- eISSN
- 1095-8673
- Language
- English
- Date published
- 11/2018
- Academic Unit
- Medical Ethics; Stead Family Department of Pediatrics; Surgery; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094526802771
Metrics
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