Medical Decision Making最新文献

{"title":"Overestimation of Survival Rates of Cardiopulmonary Resuscitation Is Associated with Higher Preferences to Be Resuscitated: Evidence from a National Survey of Older Adults in Switzerland.","authors":"Clément Meier, Sarah Vilpert, Maud Wieczorek, Gian Domenico Borasio, Ralf J Jox, Jürgen Maurer","doi":"10.1177/0272989X231218691","DOIUrl":"10.1177/0272989X231218691","url":null,"abstract":"<p><strong>Background: </strong>Many widely used advance directives templates include direct questions on individuals' preferences for cardiopulmonary resuscitation (CPR) in case of decision-making incapacity during medical emergencies. However, as knowledge of the survival rates of CPR is often limited, individuals' advance decisions on CPR may be poorly aligned with their preferences if false beliefs about the survival rates of CPR shape stated preferences for CPR.</p><p><strong>Methods: </strong>We analyzed nationally representative data from 1,469 adults aged 58+ y who responded to wave 8 (2019/2020) of the Swiss version of the Survey on Health, Ageing, and Retirement in Europe (SHARE) to assess the partial association between knowledge of CPR survival rates and stated preferences for CPR using multivariable probit regression models that adjust for social, health, and regional characteristics. Knowledge of CPR survival rates was assessed by asking how likely it is in general in Switzerland for a 70-y-old to survive until hospital discharge from a CPR performed outside of a hospital. Preferences for CPR were measured by asking respondents if they would wish to be resuscitated in case of cardiac arrest.</p><p><strong>Results: </strong>Only 9.3% of respondents correctly assessed the chances for a 70-y-old to survive until hospital discharge from a CPR performed outside of a hospital, while 65.2% indicated a preference to be resuscitated in case of a cardiac arrest. Respondents who correctly assessed CPR survival were significantly more likely to wish not to be resuscitated (average marginal effect: 0.18, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Reducing misconceptions concerning the survival rates of CPR could change older adults' preferences for CPR and make them more likely to forgo such treatments.</p><p><strong>Highlights: </strong>Many older adults in Switzerland overestimate the survival rates of cardiopulmonary resuscitation (CPR).The study reveals that individuals with accurate knowledge of CPR survival rates are more likely to refuse resuscitation in case of cardiac arrest.Overestimation of CPR survival rates may lead to a mismatch between individuals' preferences for CPR and their actual end-of-life care decisions.Improving the general population's knowledge of CPR survival rates is crucial to ensure informed decision making and effective advance care planning.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Discrete Choice Experiment with Swing Weighting to Estimate Attribute Relative Importance: A Case Study in Lung Cancer Patient Preferences.","authors":"J Veldwijk, I P Smith, S Oliveri, S Petrocchi, M Y Smith, L Lanzoni, R Janssens, I Huys, G A de Wit, C G M Groothuis-Oudshoorn","doi":"10.1177/0272989X231222421","DOIUrl":"10.1177/0272989X231222421","url":null,"abstract":"<p><strong>Introduction: </strong>Discrete choice experiments (DCE) are commonly used to elicit patient preferences and to determine the relative importance of attributes but can be complex and costly to administer. Simpler methods that measure relative importance exist, such as swing weighting with direct rating (SW-DR), but there is little empirical evidence comparing the two. This study aimed to directly compare attribute relative importance rankings and weights elicited using a DCE and SW-DR.</p><p><strong>Methods: </strong>A total of 307 patients with non-small-cell lung cancer in Italy and Belgium completed an online survey assessing preferences for cancer treatment using DCE and SW-DR. The relative importance of the attributes was determined using a random parameter logit model for the DCE and rank order centroid method (ROC) for SW-DR. Differences in relative importance ranking and weights between the methods were assessed using Cohen's weighted kappa and Dirichlet regression. Feedback on ease of understanding and answering the 2 tasks was also collected.</p><p><strong>Results: </strong>Most respondents (>65%) found both tasks (very) easy to understand and answer. The same attribute, survival, was ranked most important irrespective of the methods applied. The overall ranking of the attributes on an aggregate level differed significantly between DCE and SW-ROC (<i>P</i> < 0.01). Greater differences in attribute weights between attributes were reported in DCE compared with SW-DR (<i>P</i> < 0.01). Agreement between the individual-level attribute ranking across methods was moderate (weighted Kappa 0.53-0.55).</p><p><strong>Conclusion: </strong>Significant differences in attribute importance between DCE and SW-DR were found. Respondents reported both methods being relatively easy to understand and answer. Further studies confirming these findings are warranted. Such studies will help to provide accurate guidance for methods selection when studying relative attribute importance across a wide array of preference-relevant decisions.</p><p><strong>Highlights: </strong>Both DCEs and SW tasks can be used to determine attribute relative importance rankings and weights; however, little evidence exists empirically comparing these methods in terms of outcomes or respondent usability.Most respondents found the DCE and SW tasks very easy or easy to understand and answer.A direct comparison of DCE and SW found significant differences in attribute importance rankings and weights as well as a greater spread in the DCE-derived attribute relative importance weights.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Economic Evaluations with Value of Information Analyses Using the CHEERS Value of Information (CHEERS-VOI) Reporting Guideline.","authors":"Natalia Kunst, Annisa Siu, Michael Drummond, Sabine Grimm, Janneke Grutters, Don Husereau, Hendrik Koffijberg, Claire Rothery, Edward C F Wilson, Anna Heath","doi":"10.1177/0272989X231214791","DOIUrl":"10.1177/0272989X231214791","url":null,"abstract":"","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Mortality alongside 5-Year Survival Rates and Incidence on the Public's Perceived Benefits of Cancer Screening and Screening Intention: A Web-Based Experimental Study.","authors":"Soyun Kim","doi":"10.1177/0272989X231218278","DOIUrl":"10.1177/0272989X231218278","url":null,"abstract":"<p><strong>Background: </strong>Mortality is critical information in evaluating the benefits of cancer screening. However, 5-y survival rates and incidence, without mortality, have been frequently communicated to the public. Based on the literature that people's perceptions and judgments can be altered by the way of presenting health statistics, the current study examined whether mortality alongside 5-y survival and incidence would influence laypeople's perceptions of the effectiveness of cancer screening and screening intention.</p><p><strong>Methods: </strong>In an online-based experimental survey conducted in South Korea in October 2022, 300 adults were randomly assigned to 1 of 2 groups (mortality: no v. yes) to be presented with 3 different cancers (A, B, and C). The perceived effectiveness of cancer screening and screening intention were measured using 7-point scales for each cancer.</p><p><strong>Results: </strong>Across all cancers, participants in the no-mortality group perceived cancer screening to be more effective and were more willing to undergo screening compared with those in the mortality group, although the results were not statistically significant on the intention.</p><p><strong>Conclusions: </strong>In general, mortality had an effect of decreasing the perceived effectiveness of cancer screening and screening intention compared with no mortality, although the effect on the intention was not statistically significant.</p><p><strong>Implications: </strong>When communicating the benefits of cancer screening to the public, mortality statistics may play a role in mitigating the potentially inflated perception of the benefits of cancer screening and screening intention.</p><p><strong>Highlights: </strong>Five-year survival rates, either alone or with incidence rates, are frequently communicated to the public in the context of the benefits of cancer screening.However, 5-y survival rates can sometimes be inflated without a reduction in mortality.Including mortality statistics in communications decreased the perceived effectiveness of cancer screening and screening intentions.Mortality information needs to be communicated in the benefits of cancer screening.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of COVID-19 Risk: How Did People Adapt to the Novel Risk?","authors":"Karen Sepucha, Aaron Rudkin, Ryan Baxter-King, Annette L Stanton, Neil Wenger, Lynn Vavreck, Arash Naeim","doi":"10.1177/0272989X231221448","DOIUrl":"10.1177/0272989X231221448","url":null,"abstract":"<p><strong>Background: </strong>There is limited understanding of how risk perceptions changed as the US population gained experience with COVID-19. The objectives were to examine risk perceptions and determine the factors associated with risk perceptions and how these changed over the first 18 mo of the pandemic.</p><p><strong>Methods: </strong>Seven cross-sectional online surveys were fielded between May 2020 and October 2021. The study included a population-weighted sample of 138,303 US adults drawn from a market research platform, with an average 68% cooperation rate. Respondents' risk perception of developing COVID in the next 30 days was assessed at each time point. We examined relationships between 30-day risk perceptions and various factors (including sociodemographic features, health, COVID-19 experience, political affiliation, and psychological variables).</p><p><strong>Results: </strong>COVID risk perceptions were stable across the 2020 surveys and showed a significant decrease in the 2021 surveys. Several factors, including older age, worse health, high COVID worry, in-person employment type, higher income, Democratic political party affiliation (the relatively more liberal party in the United States), low tolerance of uncertainty, and high anxiety were strongly associated with higher 30-d risk perceptions in 2020. One notable change occurred in 2021, in that younger adults (aged 18-29 y) had significantly higher 30-d risk perceptions than older adults did (aged 65 y and older) after vaccination. Initial differences in perception by political party attenuated over time. Higher 30-d risk perceptions were significantly associated with engaging in preventive behaviors.</p><p><strong>Limitations: </strong>Cross-sectional samples, risk perception item focused on incidence not severity.</p><p><strong>Conclusions: </strong>COVID risk perceptions decreased over time. Understanding the longitudinal pattern of risk perceptions and the factors associated with 30-d risk perceptions over time provides valuable insights to guide public health communication campaigns.</p><p><strong>Highlights: </strong>The study assessed COVID-19 risk perceptions at 7 time points over 18 mo of the pandemic in large samples of US adults.Risk perceptions were fairly stable until the introduction of vaccines in early 2021, at which point they showed a marked reduction.Higher COVID-19 30-d risk perceptions were significantly associated with the preventive behaviors of masking, limiting social contact, avoiding restaurants, and not entertaining visitors at home.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139465795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Smoking Status in Making Risk-Informed Diagnostic Decisions in the Lung Cancer Pathway: A Qualitative Study of Health Care Professionals and Patients.","authors":"Georgia B Black, Sam M Janes, Matthew E J Callister, Sandra van Os, Katriina L Whitaker, Samantha L Quaife","doi":"10.1177/0272989X231220954","DOIUrl":"10.1177/0272989X231220954","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer clinical guidelines and risk tools often rely on smoking history as a significant risk factor. However, never-smokers make up 14% of the lung cancer population, and this proportion is rising. Consequently, they are often perceived as low-risk and may experience diagnostic delays. This study aimed to explore how clinicians make risk-informed diagnostic decisions for never-smokers.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with 10 lung cancer diagnosticians, supported by data from interviews with 20 never-smoker lung cancer patients. The data were analyzed using a framework analysis based on the Model of Pathways to Treatment framework and data-driven interpretations.</p><p><strong>Results: </strong>Participants described 3 main strategies for making risk-informed decisions incorporating smoking status: guidelines, heuristics, and potential harms. Clinicians supplemented guidelines with their own heuristics for never-smokers, such as using higher thresholds for chest X-ray. Decisions were easier for patients with high-risk symptoms such as hemoptysis. Clinicians worried about overinvestigating never-smoker patients, particularly in terms of physical and psychological harms from invasive procedures or radiation. To minimize unnecessary anxiety about lung cancer risk, clinicians made efforts to downplay this. Conversely, some patients found that this caused process harms such as delays and miscommunications.</p><p><strong>Conclusion: </strong>Improved guidance and methods of risk differentiation for never-smokers are needed to avoid diagnostic delays, overreassurance, and clinical pessimism. This requires an improved evidence base and initiatives to increase awareness among clinicians of the incidence of lung cancer in never-smokers. As the proportion of never-smoker patients increases, this issue will become more urgent.</p><p><strong>Highlights: </strong>Smoking status is the most common risk factor used by clinicians to guide decision making, and guidelines often focus on this factor.Some clinicians also use their own heuristics for never-smokers, and this becomes particularly relevant for patients with lower risk symptoms.Clinicians are also concerned about the potential harms and risks associated with deploying resources on diagnostics for never-smokers.Some patients find it difficult to decide whether or not to go ahead with certain procedures due to efforts made by clinicians to downplay the risk of lung cancer.Overall, the study highlights the complex interplay between smoking history, clinical decision making, and patient anxiety in the context of lung cancer diagnosis and treatment.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bias-Adjusted Predictions of County-Level Vaccination Coverage from the COVID-19 Trends and Impact Survey.","authors":"Marissa B Reitsma, Sherri Rose, Alex Reinhart, Jeremy D Goldhaber-Fiebert, Joshua A Salomon","doi":"10.1177/0272989X231218024","DOIUrl":"10.1177/0272989X231218024","url":null,"abstract":"<p><strong>Background: </strong>The potential for selection bias in nonrepresentative, large-scale, low-cost survey data can limit their utility for population health measurement and public health decision making. We developed an approach to bias adjust county-level COVID-19 vaccination coverage predictions from the large-scale US COVID-19 Trends and Impact Survey.</p><p><strong>Design: </strong>We developed a multistep regression framework to adjust for selection bias in predicted county-level vaccination coverage plateaus. Our approach included poststratification to the American Community Survey, adjusting for differences in observed covariates, and secondary normalization to an unbiased reference indicator. As a case study, we prospectively applied this framework to predict county-level long-run vaccination coverage among children ages 5 to 11 y. We evaluated our approach against an interim observed measure of 3-mo coverage for children ages 5 to 11 y and used long-term coverage estimates to monitor equity in the pace of vaccination scale up.</p><p><strong>Results: </strong>Our predictions suggested a low ceiling on long-term national vaccination coverage (46%), detected substantial geographic heterogeneity (ranging from 11% to 91% across counties in the United States), and highlighted widespread disparities in the pace of scale up in the 3 mo following Emergency Use Authorization of COVID-19 vaccination for 5- to 11-y-olds.</p><p><strong>Limitations: </strong>We relied on historical relationships between vaccination hesitancy and observed coverage, which may not capture rapid changes in the COVID-19 policy and epidemiologic landscape.</p><p><strong>Conclusions: </strong>Our analysis demonstrates an approach to leverage differing strengths of multiple sources of information to produce estimates on the time scale and geographic scale necessary for proactive decision making.</p><p><strong>Implications: </strong>Designing integrated health measurement systems that combine sources with different advantages across the spectrum of timeliness, spatial resolution, and representativeness can maximize the benefits of data collection relative to costs.</p><p><strong>Highlights: </strong>The COVID-19 pandemic catalyzed massive survey data collection efforts that prioritized timeliness and sample size over population representativeness.The potential for selection bias in these large-scale, low-cost, nonrepresentative data has led to questions about their utility for population health measurement.We developed a multistep regression framework to bias adjust county-level vaccination coverage predictions from the largest public health survey conducted in the United States to date: the US COVID-19 Trends and Impact Survey.Our study demonstrates the value of leveraging differing strengths of multiple data sources to generate estimates on the time scale and geographic scale necessary for proactive public health decision making.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eliciting Risk Perceptions: Does Conditional Question Wording Have a Downside?","authors":"Jeremy D Strueder, Jane E Miller, Xianshen Yu, Paul D Windschitl","doi":"10.1177/0272989X231223491","DOIUrl":"10.1177/0272989X231223491","url":null,"abstract":"<p><strong>Background: </strong>To assess the impact of risk perceptions on prevention efforts or behavior change, best practices involve conditional risk measures, which ask people to estimate their risk contingent on a course of action (e.g., \"if not vaccinated\").</p><p><strong>Purpose: </strong>To determine whether the use of conditional wording-and its drawing of attention to one specific contingency-has an important downside that could lead researchers to overestimate the true relationship between perceptions of risk and intended prevention behavior.</p><p><strong>Methods: </strong>In an online experiment, US participants from Amazon's MTurk (<i>N</i> = 750) were presented with information about an unfamiliar fungal disease and then randomly assigned among 3 conditions. In all conditions, participants were asked to estimate their risk for the disease (i.e., subjective likelihood) and to decide whether they would get vaccinated. In 2 conditional-wording conditions (1 of which involved a delayed decision), participants were asked about their risk if they did not get vaccinated. For an unconditional/benchmark condition, this conditional was not explicitly stated but was still formally applicable because participants had not yet been informed that a vaccine was even available for this disease.</p><p><strong>Results: </strong>When people gave risk estimates to a conditionally worded risk question after making a decision, the observed relationship between perceived risk and prevention decisions was inflated (relative to in the unconditional/benchmark condition).</p><p><strong>Conclusions: </strong>The use of conditionals in risk questions can lead to overestimates of the impact of perceived risk on prevention decisions but not necessarily to a degree that should call for their omission.</p><p><strong>Highlights: </strong>Conditional wording, which is commonly recommended for eliciting risk perceptions, has a potential downside.It can produce overestimates of the true relationship between perceived risk and prevention behavior, as established in the current work.Though concerning, the biasing effect of conditional wording was small-relative to the measurement benefits that conditioning usually provides-and should not deter researchers from conditioning risk perceptions.More research is needed to determine when the biasing impact of conditional wording is strongest.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18th Biennial European Conference of the Society for Medical Decision Making, Berlin, Germany, May 21–23, 2023","authors":"","doi":"10.1177/0272989x231225267","DOIUrl":"https://doi.org/10.1177/0272989x231225267","url":null,"abstract":"","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support.","authors":"Danique W Bos-van den Hoek, Ellen M A Smets, Rania Ali, Dorien Tange, Hanneke W M van Laarhoven, Inge Henselmans","doi":"10.1177/0272989X231203693","DOIUrl":"10.1177/0272989X231203693","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effects of training general practitioners and nurses in shared decision-making (SDM) support as perceived by cancer patients and survivors.</p><p><strong>Design: </strong>An innovative, experimental design was adopted that included analogue patients (APs), that is, people who have or have had cancer and who imagine themselves in the position of the actor-patient presented in a video. Each AP assessed a video-recorded simulated consultation of a health care professional (HCP) conducted before or after an SDM support training program. The primary outcome was the APs' perceived SDM support with 13 self-developed items reflecting the perceived patient benefit of SDM support as well as the perceived HCP support behavior. Secondary outcomes included an overall rating of SDM support, AP-reported extent of SDM (CollaboRATE), satisfaction with the communication (Patient Satisfaction Questionnaire), conversation appreciation and helpfulness, as well as decision-making satisfaction and confidence (visual analog scale, 0-100). In addition, patient and HCP characteristics associated with AP-perceived SDM support were examined.</p><p><strong>Results: </strong>APs (<i>n</i> = 131) did not significantly differentiate trained from untrained HCPs in their perceptions of SDM support nor in secondary outcomes. Agreement between APs' perceptions was poor. The higher the perceived comparability of the consultation with APs' previous personal experiences, the higher their rating of SDM support.</p><p><strong>Limitations: </strong>We used a nonvalidated primary outcome and an innovative study design that should be tested in future work.</p><p><strong>Conclusions: </strong>Despite the limitations of the study design, the training seemed to not affect cancer patients' and survivors' perceived SDM support.</p><p><strong>Implications: </strong>The clinical relevance of the training on SDM support needs to be established. The variation in APs' assessments suggests patients differ in their perception of SDM support, stressing the importance of patient-tailored SDM support.</p><p><strong>Highlights: </strong>Cancer patients and survivors did not significantly differentiate trained from untrained HCPs when evaluating SDM support, and agreement between their perceptions was poor.The clinical relevance of training GPs and nurses in SDM support needs to be established.Patient-tailored SDM support may be recommended, given the variation in APs' assessments and their possible diverging perceptions of SDM support.This innovative study design (having patients watch and assess videos of simulated consultations made in the context of training evaluation) needs to be further developed.</p>","PeriodicalId":49839,"journal":{"name":"Medical Decision Making","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10714703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}