Lyon 2017

9th International
Shared Decision Making conference in Lyon, France,
July 2nd - July 5th, 2017

 

 

 

 

 

 

 

 

 

 

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Research results

 

Here, selected research findings are presented – we do not claim to provide an exhaustive list. The latest interesting research results will be added on an ongoing basis.

If you would like to suggest an article for this section, you are very welcome.

Please send an e-mail to s.dwinger@uke.de – Many thanks!

 

Risk communication

The probability of single events, e.g. of having problems with one’s sexual life if one takes fluoxetine, can be very confusing for patients. Examples are provided of how patients can interpret probabilities. In order to prevent misinterpretations, this article provides tips on how probabilities can be communicated in the best possible way in the future. Gigerenzer G, Galesic M. The Art of Risk Communication. Why do single event probabilities confuse patients? BMJ 2012. 344:e245.

 

Do patients want to be involved?

Studies show that the majority of patients explicitly wish to be involved in treatment decisions in the physician dialogue. (Coulter A, Magee H. The European patient of the future. Berkshire: Open University Press 2003.)

 

Where does shared decision-making stand in Germany?

What influence does the German health system have on patient involvement in medical decisions? What does the current state of research and the implementation of SDM in Germany look like? An overview is provided by the article: Patient Participation and Shared Decision Making in Germany - History, Agents and Current Transfer to Practice by Härter M, Müller H, Dirmaier J, Donner-Banzhoff N, Bieber C and Eich W. Z. Evid. Fortbild. Qual. Gesundh.wesen (ZEFQ) 105 (2011) 263-270.

 

What instruments exist to measure SDM?

As shared decision-making is a very young research field, new measurement instruments to record SDM are continuously being developed. In this article, you will find a structured overview of new developments in the area of measuring SDM, an overview of known scales and an outlook concerning new developments. A development is apparent in the direction of increased “dyadic measurement” (measurement of perspectives of physicians and patients) of the SDM process. Measurement of Shared Decision Making - a Review of Instruments. Scholl I, Koelewijn-van Loon M, Sepucha K, Elwyn G, Légaré F, Härter M, Dirmaier J. Z. Evid. Fortbild. Qual. Gesundh.wesen (ZEFQ) 105 (2011) 313-324.

 

Are advanced medical training programs in SDM effective?

150 physicians took part in an 8-hour training program. A voluntary SDM training program is attractive and effective for practising physicians. Self-confidence and knowledge concerning SDM are increased. (Bieber, C, Nicolai, J, Hartmann, M, Blumenstiel, K, Ringel, N, Schneider, A, Härter, M, Eich, W, Loh, A (2009) Training physicians in shared decision-making - Who can be reached and what is achieved? Patient Education and Counseling. 2009;77(1):48-54.)

 

Is it possible to measure the quality of decision aids?

Instruments were developed to measure the quality both of decision aids and of technological decision supports e.g. interactive websites. For the development of decision aids, the so-called IPDAS Statement was drawn up. This was followed in 2009 by IPDASi: A measurement instrument to assess the quality of components of decision support technologies). (Elwyn, G, O´Connor, A M, Bennett, C, et al. (2009) Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi). PLoS online, 4(3).)

 

Can SDM be applied in oncology?

A strengthened patient participation in the health system corresponds to changed societal, legal and medical framework conditions as well as to scientific evidence. In the decision-making process regarding different treatment options, a stronger patient participation can be realised if the physician-patient interaction is more strongly oriented to the Model of Shared Decision-Making. (Bergelt, C, Härter, M (2010) Partizipative Entscheidungsfindung: der Patient als Partner. [Shared decision-making: The patient as partner] best practice oncology, 5, 49-55.) Also in more depth: Reuter K, Loh A, Härter M. (2009). Patient als Partner in der Onkologie – Chancen der Partizipativen Entscheidungsfindung [Patient as partner in oncology – Opportunities of Shared Decision-Making]. In U. Koch & J. Weis (Ed.). Psychoonkologie. Eine Disziplin in der Entwicklung [Psychooncology: A developing discipline]. Göttingen: Hogrefe.

 

Are cancer-related decision aids effective?

A meta-analysis of randomised controlled studies was able to show that cancer-related decision aids are effective. Particularly in the area of cancer screening, the patients’ knowledge is increased compared to standard treatment. At the same time, anxiety is not raised. (O'Brien MA, Whelan TJ, Villasis-Keever M, Gafni A, Charles C, Roberts R, Schiff S, Cai W. Are cancer-related decision aids effective? A systematic review and meta-analysis. 2009. J Clin Oncol 27(6):974-85.)

 

What are the consequences of low health literacy?

A systematic overview work on low health literacy and treatment outcomes examined 96 studies on this theme. A lower heath competence is associated with worse treatment outcomes and lower utilisation of offers of the health care system. For instance, people with low health competence have more hospital stays, have to visit the emergency room more frequently, have fewer mammograms and more rarely get the flu vaccination. Adherence to medication is also lower and mortality is increased. (Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine. 2011. 155 (2) 97-107. )

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Update: 26. Jan. 2017