Steps of Shared Decision-Making Process During Consultation as Reported by Patients Directly After Consultation
| Steps and Statements | Intervention Group % Agree (n) | Control Group % Agree (n) | P Valuea | Estimated ICC of CME Group/Practicea |
|---|---|---|---|---|
| a After adjustment for confounders, see also methods section. | ||||
| b Because item expresses the opposite, high percentages representing less involvement of patients, it has been inverted before summing up shared decision making steps in Table 4. | ||||
| Step 1. Disclosure, that a decision needs to be made | ||||
| My doctor told me that a treatment decision is necessary | 42.9 (236/550) | 39.0 (227/582) | .160 | 0.035/0.125 |
| Step 2. Formulation of equality of partners | ||||
| My doctor asked me, if I want to participate in decision making | 64.2 (353/550) | 46.1 (268/582) | <.001 | 0.000/0.083 |
| Step 3. Equipoise statementb | ||||
| Due to my medical condition, treatment decision based on physicians’ recommendation is already clear | 53.8 (296/550) | 58.4 (340/582) | .867 | 0.000/0.000 |
| Step 4. Informing on the options’ benefits and risks | ||||
| My doctor has informed me about a variety of alternatives | 64.0 (352/550) | 47.9 (279/582) | <.001 | 0.000/0.203 |
| The possibility to choose no treatment was also discussed | 55.3 (304/550) | 36.9 (215/582) | <.001 | 0.000/0.076 |
| Step 5. Investigation of patient’s understanding and expectations | ||||
| I have mentioned other possibilities that my doctor has not referred to | 14.4 (79/550) | 8.9 (52/582) | .075 | 0.000/0.089 |
| My doctor has asked me how I think about different treatment options | 62.9 (346/550) | 37.6 (219/582) | <.001 | 0.000/0.281 |
| Step 6. Identification of preferences (both) | ||||
| I have communicated to my doctor which decision I do prefer | 55.5 (305/550) | 34.7 (202/582) | <.001 | 0.000/0.145 |
| My doctor has told me which decision he prefers | 68.9 (379/550) | 57.6 (335/582) | <.001 | 0.000/0.153 |
| Step 7. Negotiation | ||||
| In the selection of treatment method, my thoughts were taken into account just as much as the considerations of my doctor | 77.1 (424/550) | 61.3 (357/582) | <.001 | 0.001/0. 184 |
| My doctor and I weighted up the different treatment options thoroughly | 67.6 (372/550) | 51.2 (298/582) | <.001 | 0.000/0. 113 |
| Step 8. Shared decision making | ||||
| My doctor enabled me to actively participate in decision making about treatment | 79.1 (435/550) | 64.3 (374/582) | <.001 | 0.000/0.118 |
| My doctor and I selected a treatment together | 65.8 (362/550) | 55.8 (325/582) | .004 | 0.000/0.149 |
| Step 9. Arrangement of follow-up | ||||
| My doctor and I reached an agreement as to how we will proceed | 78.9 (434/550) | 70.4 (410/582) | .006 | 0.013/0. 196 |