A Simple Goal Elicitation Tool Improves Shared Decision Making in Outpatient Orthopedic Surgery: A Randomized Controlled Trial

Kevin Mertz, Romil F. Shah, Sara L. Eppler, Jeffrey Yao, Marc Safran, Ariel Palanca, Serena S. Hu, Michael Gardner, Derek F. Amanatullah and Robin N. Kamal
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Kevin Mertz: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Romil F. Shah: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Sara L. Eppler: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Jeffrey Yao: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Marc Safran: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Ariel Palanca: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Serena S. Hu: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Michael Gardner: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Derek F. Amanatullah: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA
Robin N. Kamal: VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, CA, USA

Medical Decision Making, 2020, vol. 40, issue 6, 766-773

Abstract: Introduction . Shared decision making involves educating the patient, eliciting their goals, and collaborating on a decision for treatment. Goal elicitation is challenging for physicians as previous research has shown that patients do not bring up their goals on their own. Failure to properly elicit patient goals leads to increased patient misconceptions and decisional conflict. We performed a randomized controlled trial to test the efficacy of a simple goal elicitation tool in improving patient involvement in decision making. Methods . We conducted a randomized, single-blind study of new patients presenting to a single, outpatient surgical center. Prior to their consultation, the intervention group received a demographics questionnaire and a goal elicitation worksheet. The control group received a demographics questionnaire only. After the consultation, both groups were asked to complete the Perceived Involvement in Care Scale (PICS) survey. We compared the mean PICS scores for the intervention and control groups using a nonparametric Mann-Whitney Wilcoxon test. Secondary analysis included a qualitative content analysis of the patient goals. Results . Our final cohort consisted of 96 patients (46 intervention, 50 control). Both groups were similar in terms of demographic composition. The intervention group had a significantly higher mean (SD) PICS score compared to the control group (9.04 [2.15] v. 7.54 [2.27], P

Keywords: Goal elicitation; orthopedic surgery; shared decision making (search for similar items in EconPapers)
Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:40:y:2020:i:6:p:766-773

DOI: 10.1177/0272989X20943520

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