scholarly journals Choosing Wisely and Beyond: Shared Decision Making and Chronic Kidney Disease

2013 ◽  
Vol 17 (4) ◽  
pp. 75-78 ◽  
Author(s):  
Phillip Tuso
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Shared Decision Making ◽  
Choosing Wisely ◽  
Shared Decision

scholarly journals The Need for Accurate Risk Prediction Models for Road Mapping, Shared Decision Making and Care Planning for the Elderly with Advanced Chronic Kidney Disease

PRILOZI ◽  
2016 ◽  
Vol 37 (2-3) ◽  
pp. 33-42 ◽  
Author(s):  
Marijke Stryckers ◽  
Evi V Nagler ◽  
Wim Van Biesen
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Shared Decision Making ◽  
Risk Prediction ◽  
Prediction Models ◽  
Shared Decision ◽  
End Stage Kidney Disease ◽  
Risk Prediction Models ◽  
End Stage

AbstractAs people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual’s values and preferences. Accurate estimations of one’s risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective. Formal risk prediction models can help, provided they are externally validated, well-calibrated and discriminative; include unambiguous and measureable variables; and come with readily applicable equations or scores. Reliable, externally validated risk prediction models for progression of chronic kidney disease to end-stage kidney disease or mortality in frail elderly with or without chronic kidney disease are scant. Within this paper, we discuss a number of promising models, highlighting both the strengths and limitations physicians should understand for using them judiciously, and emphasize the need for external validation over new development for further advancing the field.

The Shared Decision-Making Process as the Recommended Standard for Treatment Decisions in Kidney Disease and Requisite Communication Skills to Implement the Process

2020 ◽  
pp. 87-97
Author(s):  
Ernest I. Mandel ◽  
Jane O. Schell ◽  
Robert A. Cohen
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
Shared Decision Making ◽  
Treatment Decision ◽  
Standard Of Care ◽  
Healthcare Research ◽  
Choosing Wisely ◽  
Decision Making Process ◽  
Shared Decision ◽  
American Society

Shared decision-making (SDM) is the accepted standard of care paradigm for medical decision making between patient or surrogate and clinician. In its Choosing Wisely campaign, the American Society of Nephrology (ASN) recommended SDM prior to the initiation of dialysis. Evidence suggests that SDM enhances patients’ understanding of their illness and satisfaction with the decision-making process, but at present SDM is poorly integrated into dialysis decision-making. Dialysis patients often describe a passive role in the decision to start dialysis, reinforcing the need for implementation of SDM in decision-making with patients with kidney disease. The hallmark feature of SDM is collaboration between the clinician and the patient or surrogate whereby the patient’s expertise in the realm of values and priorities is elicited while the clinician’s medical expertise is shared. The ultimate treatment decision results from the integration of their respective expertise. The Agency for Healthcare Research and Quality SHARE Approach outlines the components of SDM, and frameworks such as the Serious Illness Conversation Guide, REMAP, and SPIRES are roadmaps for those components. Communication tools and mnemonics also facilitate SDM conversations. With knowledge and application of these frameworks and tools, the nephrology community will be better positioned to fulfill the mandate embodied in the ASN Choosing Wisely campaign to employ the SDM process in renal replacement therapy decisions.

scholarly journals Shared decision-making, advance care planning for chronic kidney disease patients

2021 ◽  
Vol 27 (5) ◽  
pp. 33
Author(s):  
ShankarPrasad Nagaraju ◽  
Jayita Deodhar ◽  
AshokL Kirpalani ◽  
AjithM Nayak
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Shared Decision Making ◽  
Advance Care Planning ◽  
Care Planning ◽  
Shared Decision ◽  
Advance Care
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