Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction

Abstract

Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common flaps—i.e., a cross-finger flap (CFF), a dorsal metacarpal artery perforator flap (DMAPF), and an arterialized venous flap (AVF)—were listed as treatment alternatives. Five attributes corresponding to these flaps were recovery time, total procedure, postoperative care methods, postoperative scar condition, and complication rate. Utility and importance scores were generated from the software, and preference characteristics were evaluated using cluster analysis. Results: The survey was completed by 197 participants with hand trauma. Complication risk received the highest importance score (42.87%), followed by scar condition (21.55%). Cluster analysis classified the participants as “conservative,” “practical,” and “dual-concern.”. The dual-concern and conservative groups had more foreign laborers and highly educated participants, respectively, than the other groups. Most participants in the conservative and practical groups preferred DMAPF, whereas those in the dual-concern group favored CFF. Our proposed model consisted of shared decision-making and treatment recommendation pathways. Conclusion: Incorporating patient preferences into the decision-making model can strengthen patient-centered care. Further research on the applications of the proposed model is warranted.

Big Data, Decision Models, and Public Health

“…Consequently, the trend in medical decision making has changed from passive informed consent to shared decision making (SDM). The fourth paper, “ Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction ”, by Chang et al [ 41 ], conducted a conjoint analysis (CA) to determine which factors are most important for patients who will undergo hand soft tissue reconstruction. Furthermore, both patients and physicians can use this information to determine what patients are willing to sacrifice to achieve their treatment goals.…”

Patient Preferences in Shared Decision Making During Healthcare and Associated Factors Among Adult Admitted Patients at Public Hospitals of West Shoa Oromia, Ethiopia

“…[8][9][10] Incorporating and understanding individuals' preferences for participating in healthcare decisions are the bases in delivering patient-centered care. 11,12 Communication is an important asset for shared decision making. 13 Patients are asked to engage in informed discussion of the risks, benefits, and alternative interventions and decide between them for the elicited preferences.…”

“…Incorporating and understanding individuals’ preferences for participating in healthcare decisions are the bases in delivering patient-centered care. 11 , 12 …”