scholarly journals The systematic use of evidence‐based methodologies and technologies enhances shared decision‐making in the 2018 International Consensus Conference on Patient Blood Management

Vox Sanguinis ◽  
2019 ◽  
Vol 115 (1) ◽  
pp. 60-71
Author(s):  
Hans Van Remoortel ◽  
Kari Aranko ◽  
Markus M. Mueller ◽  
Emmy De Buck ◽  
Dana Devine ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Consensus Conference ◽  
Evidence Based ◽  
Patient Blood Management ◽  
Shared Decision ◽  
Blood Management ◽  
International Consensus

scholarly journals Development of a contemporary evidence-based practice workshop for health professionals with a focus on pre-appraised evidence and shared decision-making: a before-after pilot study

2019 ◽  
Vol 25 (2) ◽  
pp. 1.2-2 ◽  
Author(s):  
Loai Albarqouni ◽  
Paul Glasziou ◽  
Mina Bakhit ◽  
Chris Del Mar ◽  
Tammy C Hoffmann
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Evidence Based ◽  
Shared Decision ◽  
International Consensus ◽  
Feedback Questionnaire ◽  
Approach To Teaching ◽  
Strongly Agree

Shared decision-making (SDM) has emerged as a key skill to assist clinicians in applying evidence-based practice (EBP). We aimed to develop and pilot a new approach to teaching EBP, which focuses on teaching knowledge and skills about SDM and pre-appraised evidence. We designed a half-day workshop, informed by an international consensus on EBP core competencies and invited practicing clinicians to participate. Skills in SDM and communicating evidence were assessed by audio-recording consultations between clinicians and standardised patients (immediately pre-workshop and post-workshop). These were rated by two independent assessors using the OPTION (Observing Patient Involvement, 0 to 100 points) and ACEPP (Assessing Communication about Evidence and Patient Preferences, 0 to 5 points) tools. Participants also completed a feedback questionnaire (9 Likert scale and four open-ended questions). Fourteen clinicians participated. Skills in SDM and communicating research evidence improved from pre-workshop to post-workshop (mean increase in OPTION score=5.5, 95% CI 1.0 to 9.9; increase in ACEPP score=0.5, 95% CI 0.02 to 1.06). Participant feedback was positive, with most indicating ‘agree’ or ‘strongly agree’ to the questions. A contemporary approach to teaching clinicians EBP, with a focus on SDM and pre-appraised evidence, was feasible, perceived as useful, and showed modest improvements in skills. Results should be interpreted cautiously because of the small study size and pre-post design.

scholarly journals 2018 Evidence Base of Patient Blood Management - Recommendations from the First International Consensus Conference, Frankfurt/Main, Germany

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4982-4982
Author(s):  
Markus M. Mueller ◽  
Hans van Remoortel ◽  
Patrick Meybohm ◽  
Kari Aranko ◽  
Mike Murphy ◽  
...  
Keyword(s):  
Blood Cell ◽  
Evidence Base ◽  
Consensus Conference ◽  
Evidence Based ◽  
Patient Blood Management ◽  
Blood Management ◽  
Preoperative Anemia ◽  
International Consensus ◽  
Research Recommendations ◽  
Rbc Transfusion

Introduction: The analysis of published clinical trial results is essential for the evidence base of patient blood management (PBM). In addition, an evidence-based way of developing guidelines and recommendation is indispensable for high quality patient-centred hemotherapy. The international Consensus Conference (ICC) was set up in order to develop evidence-based clinical and research recommendations for preoperative anemia, red blood cell (RBC) transfusion thresholds in adult patients and implementation of PBM programmes. Methods: An international scientific committee (SC) defined 17 population-intervention-comparison-outcome (PICO) questions for the three topics preoperative anemia, red blood cell (RBC) transfusion thresholds in adult patients and implementation of PBM. From these 17 PICO questions, literature search was conducted in four biomedical databases. Several meta-analyses, forest plots, the GRADE methodology (= grading of recommendations, assessment, development and evaluation), GRADEpro, the open source online database for GRADE as well as the Evidence-to-Decision (EtD) framework were used in order to keep the development of recommendations as evidence-based and transparent as possible. Three expert panels (EP) consisting of clinicians, scientists, nurses, patient representatives and methodologists were established and used the methods described above in order to develop recommendations driven by published evidence. Results: Out of more than 17,500 literature citations, data from 145 studies (63 randomised trials including more than 23,000 patients (pts.) & 82 observational studies including more than 4 million pts.) was incorporated into the final analysis. The expert panel for preoperative anemia developed 4 clinical and 3 research recommendations. A strong recommendation advocates for early detection and management of preoperative anemia before major elective surgery. For RBC transfusion thresholds, 4 clinical and 6 research recommendations came out of the process. Two strong clinical recommendations for PBC transfusion thresholds advocate a hemoglobin level (hb) of < 7 g/dL for critical ill, but clinical stable adult intensive care patients independent of septic shock and < 7.5 g/dL for adults undergoing cardiac surgery. For implementation of PBM programmes, 2 clinical and 3 research recommendations were defined. Research recommendations define open fields in PBM and try to initiate additional studies in order to answer still open questions. Conclusion: This is the first ICC for PBM defining the evidence base for three clinically important hemotherapy topics. The relative paucity of strong evidence in current PBM literature underscores the ongoing struggle to a.) find internationally accepted definitions e.g. for anemia and b.) execute internationally planned meaningful multicentre trials in the still open fields of PBM. The clinical recommendations found here however should be considered and accepted in clinical practice. Disclosures Seifried: Medac: Other: BSD owns IP and is contract manufacturer; Uniqure BV: Research Funding.

scholarly journals Engaging Multidisciplinary Stakeholders to Drive Shared Decision-Making in Oncology

2018 ◽  
Vol 34 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Gabrielle Rocque ◽  
Ellen Miller-Sonnet ◽  
Alan Balch ◽  
Carrie Stricker ◽  
Josh Seidman ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Best Practices ◽  
Shared Decision Making ◽  
Best Practice ◽  
Care Delivery ◽  
Evidence Based ◽  
Shared Decision ◽  
Oncology Practice ◽  
Development And Validation

Although recognized as best practice, regular integration of shared decision-making (SDM) approaches between patients and oncologists remains an elusive goal. It is clear that usable, feasible, and practical tools are needed to drive increased SDM in oncology. To address this goal, we convened a multidisciplinary collaborative inclusive of experts across the health-care delivery ecosystem to identify key principles in designing and testing processes to promote SDM in routine oncology practice. In this commentary, we describe 3 best practices for addressing challenges associated with implementing SDM that emerged from a multidisciplinary collaborative: (1) engagement of diverse stakeholders who have interest in SDM, (2) development and validation of an evidence-based SDM tool grounded within an established conceptual framework, and (3) development of the necessary roadmap and consideration of the infrastructure needed for engendering patient engagement in decision-making. We believe these 3 principles are critical to the success of creating SDM tools to be utilized both within and outside of clinical practice. We are optimistic that shared use across settings will support adoption of this tool and overcome barriers to implementing SDM within busy clinical workflows. Ultimately, we hope that this work will offer new perspectives on what is important to patients and provide an important impetus for leveraging patient preferences and values in decision-making.

scholarly journals What are the links between evidence-based medicine and shared decision-making in training programs for junior doctors? A scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e037225
Author(s):  
Mary Simons ◽  
Frances Rapport ◽  
Yvonne Zurynski ◽  
Jeremy Cullis ◽  
Andrew Davidson
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Scoping Review ◽  
Evidence Based Medicine ◽  
Cochrane Library ◽  
Junior Doctors ◽  
Evidence Based ◽  
Shared Decision ◽  
Patient Centred Care ◽  
Based Medicine

IntroductionPatient-centred care is pivotal to clinical practice and medical education. The practice of evidence-based medicine (EBM) and shared decision-making (SDM) are complementary aspects of patient-centred care, but they are frequently taught and reported as independent entities. To effectively perform all steps of EBM, clinicians need to include patients in SDM conversations, however, the uptake of this has been slow and inconsistent. A solution may be the incorporation of SDM into EBM training programmes, but such programmes do not routinely include SDM skills development. This scoping review will survey the literature on the kinds of EBM and SDM educational programmes that exist for recently qualified doctors, programmes that incorporate the teaching of both EBM and SDM skills, as well as identifying research gaps in the literature.Methods and analysisLiterature searches will be conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of key articles and their citing references will also be hand-searched and assessed for inclusion. Selected grey literature will be included. Papers must be written in English, or provide English abstracts, and date from 1996 to the present day.Two independent reviewers will screen titles and abstracts, check full texts of selected papers for eligibility and extract the data. Any disagreement will be resolved, and consensus reached, if necessary, with the assistance of a third reviewer. Qualitative and quantitative studies that address educational interventions for either EBM, SDM or both will be included. Data extraction tables will present bibliographic information, populations, interventions, context and outcomes. Data will be summarised using tables and figures and a description of findings.Ethics and disseminationThis review will synthesise information from publicly available publications and does not require ethics approval. The results will be disseminated via conference presentations and publications in medical journals.

Sign in / Sign up

Export Citation Format

Share Document