Abstract:

Medical treatment of patients always entails the risk of undesired complications or side effects. This is particularly poignant in surgery as both the disease to be treated and the surgical intervention to be performed can be life threatening. Hence, it is essential to inform a surgical patient in detail about the expectations desired, but also the possible undesired outcomes and complications, especially when new surgical techniques are introduced. Apart from communication about available evidence regarding treatment options, the patient’s preference needs to be invoked to make sure the surgeon’s advice matches the patient’s preference. Shared decision-making (SDM) invokes the bidirectional communication between physicians and patients required to involve the patient’s preference in the eventual treatment choice. SDM is considered as an essential part of evidence-based medicine as it helps determine whether the available evidence on the possible benefits and harms of treatment options match the patient’s characteristics and preferences. This paper will exemplify what SDM is, why it is important, and how it can be performed in surgical practice. Several tools to facilitate SDM are presented.

Authors:

Dirk T. Ubbink, MD PhD, Senior Research Physician and Clinical Epidemiologist, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands, Michiel G. J. S. Hageman, MD, Resident in Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands,  Dink A. Legemate, MD PhD, Professor of Surgery and Clinical Epidemiologist, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands

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