EBM - Risk Communication in Shared Decision Making Flashcards
Clinical decisions should be made at the intersection of… (3)
- Patient preferences
- Clinical expertise
- Evidence (research)
In family medicine, we strive for…
a) patient centered care
b) target-centered care
a) patient-centered care
What type of decision-making should take place in family medicine?
Shared decision-making
What is overdiagnosis?
Labeling a person with a disease or abnormal condition that wold not have caused the person harm had it been left undiscovered.
Define shared decision making
Process by which a healthcare choice is made by the patient, significant other, or both with one or more healthcare professionals
When is SDM most relevant?
When benefits and harms are close
Two core elements of SDM
- risk communication
- values clarification
4 steps of SDM
- Identify a clear decision point
- Provide info about options
3.Elicit patient perspective - Guide (do not direct) the patient to a decision
How should you explain different options to a patient?
- Using natural frequencies rather than percentages (out of 1000 people)
- Infographics
- Decision aids
SURE screening test (assess how comfortable the patient is with the decision)
- S: Sure of myself
- U: Understands info
- R: Risk vs benefits
E: Encouragement
When should you not participate in SDM?
- When there is no equipoise (no decision to be made)
- When the patient cannot collaborate in the process (e.g. dementia)
- The balance between benefits and harms is not in equipoise
2 tools to support SDM
- infographics
- decision aids
Always use absolute risk! Not relative risk.
Do not use percentages!
Do not use 1 in X!
Do not use technical language (e.g. negative test instead of normal test)
