Doctor-patient shared decision making is an expansion and extension of the patient-centered concept, which emphasizes communication and collaboration between doctors and patients in making decisions, focuses on patients, needs, enhances communication and exchange between doctors and patients, and improves the status of patients in medical decision making. This paper reviews the concept, domestic and international research overview, advantages, and application of doctor-patient shared decision making in hip and knee arthroplasty, and discusses the future research directions, in order to provide a reference for the application of shared decision making between doctors and patients in hip and knee arthroplasty in China.
ObjectiveTo systematically review the efficacy of patient decision aids (PDA) in the selection of treatment modalities for end-stage renal diseases. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to March 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Quantitative and qualitative analysis was then performed. ResultsA total of 8 RCTs involving 1 544 patients were included. The systematic review results showed that PDA could improve patient knowledge, reduce patient decision-making conflict, and change patient decision-making discussion rate. ConclusionCurrent evidence shows that patients with end-stage renal diseases can benefit from PDA to improve their decision-making knowledge and reduce conflicts in their decisions, but its impact on the decision-making outcome index is limited.
ObjectiveTo overview the systematic reviews of the efficacy of cancer patient decision aids (PDAs) for treatment decision-making. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CINAHL, JBI, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect the systematic reviews relevant to the objective from inception to September 2023. Literature screening, data extraction, methodological quality assessment of the included literature, and summary and grading of the evidence were carried out independently by two researchers, and duplication of original studies in the included systematic evaluations was investigated using the corrected covered area (CCA). ResultsA total of 17 systematic reviews were included, of which 13 (76.47%) were low- or very low-quality studies. A total of 64 pieces of evidence were included, of which only 26 (40.62%) were of moderate quality, and the original studies included in the included literature had a low degree of overlap (CCA=0.05). The results of meta-analysis showed that PDAs could increase decision-related knowledge, reduce decision conflict and regret in cancer patients' treatment decision (P<0.05). However, there was no significant difference in decision satisfaction, anxiety or depression (P>0.05). ConclusionPDAs can improve cancer patients' knowledge related to treatment decision, reduce decision conflicts and regrets, and have no significant negative effects on decision preparation, satisfaction, anxiety, and depression. However, the existing systematic reviews are of low quality and limited to a few cancer types.