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September 6, 2019 · Leave a Comment

Purposeful SDM: Our new model of shared decision making

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

There are many situations in which patients and clinicians need to and are making decisions together, arguably these are all instances of Shared Decision Making (SDM). The ways that patients and clinicians make decisions should change according to the problem that is the reason why decisions are being made. For example, how patients and clinicians […]

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August 30, 2019 · Leave a Comment

Reflecting on and making sense of shared decision making

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Measuring shared decision making (SDM) is challenging. Previous research showed discrepancies between observer-based and self-reported scores. Patient-reported SDM scores are usually higher and tend to have ceiling effects (high scores without much variance), possibly due to halo effects (difficulty to disentangle SDM from overall experience of care). We wanted to test whether introducing a pause […]

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July 2, 2019 · Leave a Comment

Decision aids that facilitate elements of shared decision making in chronic illnesses

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Thomas Wieringa Shared decision making (SDM) is a patient-centered approach in which clinicians and patients work together to find and choose the best course of action for each patient’s particular situation [1]. This approach is pertinent to the care of patients with chronic conditions [2]. Six key elements of shared decision making can […]

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June 10, 2019 · Leave a Comment

Shared Decision Making with patients who have Limited English Proficiency

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Amelia Barwise The importance of shared decision making (SDM) is widely recognized and its practice is encouraged. However, some people face major challenges as they are invited to participate in SDM, and may not recognize or understand the concept of SDM within healthcare. There is a limited amount of literature about SDM in […]

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May 16, 2019 · Leave a Comment

Supporting Implementation of Shared Decision Making for Statin Therapy Initiation in Primary Care

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Aaron Leppin Decisions on whether to initiate statin therapy for cardiovascular risk reduction should be based on individual patient risk and occur in the context of a shared decision making (SDM) conversation. The Statin Choice Conversation Aid is a web-based tool that incorporates patient variables to calculate and present an individual-level risk. It […]

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April 29, 2019 · Leave a Comment

Patient explicit consideration of tradeoffs: a Values Clarification Method

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Arwen H. Pieterse In oncology, as in other healthcare settings, shared decision making (SDM) is increasingly advocated when more than one treatment strategy is available. However, we previously found that cancer patient treatment preferences are often left undiscussed, and that patients are hardly involved in treatment decision making.  If patients are unclear about […]

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March 22, 2019 · Leave a Comment

Technical versus Humanistic Shared Decision Making revisited: Evaluating its occurrence

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Marleen Kunneman & Victor Montori In an earlier post, we reflected on technically correct and humanistic shared decision making (SDM). In our view, it is unclear “whether having a technically correct structure of the SDM process improves the likelihood that the care decisions made will contribute to improve the patient situation.” We called […]

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March 19, 2019 · Leave a Comment

Trust and shared decision making

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

By Victor Montori At the beginning of our research journey into shared decision making (SDM), we thought that fostering collaboration between patients and clinicians would promote their partnership and advance mutual trust. Yet, in this trial reported in 2008, we only measured patient trust in the clinician, and we found that disclosing uncertainty (as the […]

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October 29, 2018 · Leave a Comment

Technical versus Humanistic Shared Decision Making

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by  Marleen Kunneman, Fania R Gärtner, Ian G Hargraves, Victor M Montori   In a recent commentary published in the Journal of Argumentation in Context, we aimed to draw a contrast between technically correct shared decision making (SDM), and a humanistic approach to SDM.1 We stated: “To address a patient’s problematic situation, patients and clinicians […]

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October 22, 2018 · Leave a Comment

Listening

By Kirsten Fleming Kirsten Fleming (@kirstenfleming)

Submitted by Dorothea Lagrange Throughout Europe there are many beggars from poorer countries. They are seldom welcome. What often gets lost in the rhetoric around these individuals is that these are real people, people who are often vulnerable and in need. In Sweden, where I live, I often encounter these beggars. I wish to tell […]

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