Paul Ciaravino
Pronouns: He/him
Research Mentor(s): Joshua Rager
Research Mentor School/College/Department: Internal Medicine, Division of General Medicine / Medicine
Program:
Authors: Paul Ciaravino, Joshua Rager, Winson Li, Riley DenUyl
Session: Session 5: 2:40 pm – 3:30 pm
Poster: 12
Abstract
Introduction: Shared decision making (SDM) is a process by which clinicians and patients work together to make decisions and select tests, treatments and care plans based on the best available medical evidence and patient preferences and values. However, some argue that there is limited SDM instruction in clinical practice guidelines, which are created to inform physicians of recommended healthcare practices. We conducted a systematic search of guidelines for the US general internist to estimate the frequency of SDM recommendations. It was hypothesized that less than half of the guidelines reviewed would include recommendations for SDM. Methods: As a part of a larger systematic search, we searched all Preventive Care guidelines within the ECRI Guidelines Trust (a large guideline database). Titles and abstracts were initially screened and excluded if published before 2010 or were not produced by U.S. medical societies or institutes. Remaining guidelines underwent full text review and a guideline was included if the phrase “shared decision-making” and/or the words “values” and “preferences” in the context of SDM appeared in the guideline. The title of the guideline, the year it was published, and the society or institute that published it were recorded as well. Results and Conclusions: 239 guidelines were identified on ECRI’s preventive care database. After initial screening, 63 guidelines were found to have met the inclusion criteria stated in the methods section and underwent further eligibility review. 87%(n=55) included at least one SDM recommendation. While these results suggest a high proportion of SDM recommendations in current guidelines, future research can be done to determine ways in which guidelines can suggest SDM in a more clear and actionable way as SDM recommendations can often be vague and ambiguous.
