Evidence‐Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences

Naunheim, Matthew R.; Randolph, Gregory W.; Shin, Jennifer J.

doi:10.1177/0194599820950723

Cited by 9 publications

(10 citation statements)

References 70 publications

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“…Following the core idea of cautiousness and accuracy, EBM uses the latest research evidence available to formulate a treatment plan that best suits the patient's actual situation, plus the doctor's own professional skills and rich clinical experience, based on the patient's own pathological conditions and personal willingness. It represents the reform of medical education, the change of medical model, and the new definition of medical authority [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine

Wang¹,

Chen²,

Peng

et al. 2021

Journal of Healthcare Engineering

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This study focuses on clinical pathways guided by evidence-based medicine (EBM). With the clinical pathway as the center, the subjective and objective medical knowledge of medical staff are collected, and a clinical pathway management system guided by EBM is established through a unified process; user demand analysis; main considerations; implementation, evaluation, and monitoring of the clinical path; and dictionary maintenance, to help hospitals fully regulate medical behaviors. Next, the study displays the path access prompt box, area 1 management page, table management page, exit prompt box, mutation record page, doctor order interface, revocation of execution, and monitoring interface, and the system designed is compared with the Beijing Shankang Technology (ASK) clinical data management system in terms of user experience. The results showed that the reporting rate of medical adverse events in the system in this study was 0.21%, and the work efficiency was increased by 14%. In terms of users’ satisfaction, the hospital managers’ satisfaction was 84 ± 5.36%, and it was 95 ± 4.72% for medical staff and 88 ± 4.91% for system administrators, superior to the ASK system; the differences were statistically significant ( P < 0.05 ). In conclusion, the clinical pathway information management system is in line with the working environment of medical staff, and the synchronous monitoring and management of medical quality are achieved through digital means, which can reduce the occurrence of medical adverse events and improve the work efficiency of medical staff.

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Section: Introductionmentioning

confidence: 99%

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine

Wang¹,

Chen²,

Peng

et al. 2021

Journal of Healthcare Engineering

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show abstract

“…This would support the idea of shared decision-making by putting the patient even more at the center of the treatment decision. This is particularly important, as in the absence of a preference assessment for patients, physicians may replace their patients' preferences with their own preferences [48][49][50] . Knowing that the average preferences of patients and their treating physicians are not far apart might defuse this conflict and further suggests that a patient can be somewhat confident that their treating physician's professional perception is in line with the patient's interests.…”

Section: Discussionmentioning

confidence: 99%

Identification of Relevant Attributes for Liver Cancer Therapies (IRALCT): a maximum-difference-scaling analysis

Hensen

Winkelmann

Wacker

et al. 2022

Sci Rep

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The Identification of Relevant Attributes for Liver Cancer Therapies (IRALCT) project is intended to provide new insights into the relevant utility attributes regarding therapy choices for malignant primary and secondary liver tumors from the perspective of those who are involved in the decision-making process. It addresses the potential value of taking patients’ expectations and preferences into account during the decision-making and, when possible, adapting therapies according to these preferences. Specifically, it is intended to identify the relevant clinical attributes that influence the patients’, medical laymen’s, and medical professionals’ decisions and compare the three groups’ preferences. We conducted maximum difference (MaxDiff) scaling among 261 participants (75 physicians, 97 patients with hepatic malignancies, and 89 medical laymen) to rank the importance of 14 attributes previously identified through a literature review. We evaluated the MaxDiff data using count analysis and hierarchical Bayes estimation (HB). Physicians, patients, and medical laymen assessed the same 7 attributes as the most important: probability (certainty) of a complete removal of the tumor, probability of reoccurrence of the disease, pathological evidence of tumor removal, possible complications during the medical intervention, welfare after the medical intervention, duration and intensity of the pain, and degree of difficulty of the medical intervention. The cumulative relative importance of these 7 attributes was 88.3%. Our results show that the physicians’, patients’, and medical laymen’s preferences were very similar and stable.Trial registration DRKS-ID of the study: DRKS00013304, Date of Registration in DRKS: 2017/11/16.

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“…While there are few preference studies in otolaryngology relating to either the structural or outcome-related aspects of care, this information is important. 31 Doctors and surgeons are prone to “preference misdiagnosis,” which can lead to suboptimal decision making. 1 , 32 While this study is limited in scope to what drives patients to see a laryngologist, it provides insight into what patients prioritize during their evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…While there are few preference studies in otolaryngology relating to either the structural or outcome‐related aspects of care, this information is important 31 . Doctors and surgeons are prone to “preference misdiagnosis,” which can lead to suboptimal decision making 1,32 .…”

Section: Discussionmentioning

confidence: 99%

How Patients Choose a Laryngologist: A Pilot Stated Preference Study

et al. 2021

Self Cite

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Objective Patients consider many factors when deciding how to receive medical care. This study used best-worst scaling (BWS), a technique novel to otolaryngology, to quantitatively examine preferences among patients choosing a laryngologist. Our objective was to quantify in a pilot cohort the relative importance patients place on a variety of attributes when seeking a laryngologist. Study Design BWS survey. Setting Academic voice clinic. Methods New patients were recruited to take a computerized BWS survey developed using attributes derived from patient input, expert opinion, and literature review. Attributes were grouped into 4 categories: physician reputation, physician qualifications, hospital-related factors, and other nonclinical factors. Responses were analyzed using multinomial logit regression to determine importance scores and associations with other variables. Results Eighty-seven of 93 patients recruited participated (93.5% response rate). Physician qualifications were the most important attributes to patients, with specialty laryngology training receiving the highest importance score (20.8; 95% CI, 20.2 to 21.5; P < .0001). Recommendations from referring physicians (15.6; 95% CI, 14.3 to 16.9) and use of cutting-edge technology (11.9; 95% CI, 10.7 to 13.1) were the second and third most important, respectively. Least important were nonclinical factors, including wait time to get an appointment (4.3; 95% CI, 2.8 to 5.8) and convenience of office location (1.5; 95% CI, 0.9 to 2.1). Just over half of patients (51.2%) reported willingness to wait 4 weeks for an appointment with a laryngologist. Older patients were less concerned with convenience-related factors. Conclusion Nonclinical factors were less important to patients than clinical factors, and laryngology-specific training was paramount. Stated preference methodologies can elucidate underlying preferences and help providers make care more patient centered.

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Evidence‐Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences

Cited by 9 publications

References 70 publications

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine

Construction of Clinical Pathway Information Management System under the Guidance of Evidence-Based Medicine

Identification of Relevant Attributes for Liver Cancer Therapies (IRALCT): a maximum-difference-scaling analysis

How Patients Choose a Laryngologist: A Pilot Stated Preference Study

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