Sepucha Karen R, Breslin Maggie, Graffeo Charles, Carpenter Christopher R, Hess Erik P
Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA.
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN.
Acad Emerg Med. 2016 Dec;23(12):1325-1331. doi: 10.1111/acem.13071. Epub 2016 Dec 7.
Shared decision making (SDM) has been advocated as an approach to selecting medical tests and treatments for many situations. The goal of SDM is to ensure that patients are well informed, are meaningfully involved in decisions, and receive treatments that meet their goals and preferences. There is considerable evidence about the tools used to promote SDM, called patient decision aids, and many different measures have been developed to assess the impact of SDM. However, fairly little is known about the applicability of the tools and measures in the emergency department (ED) setting. This article builds on insights from two keynote lectures presented at the 2016 Academic Emergency Medicine Consensus Conference discussing the state of the science for measurement of SDM and the design of patient decision aids to promote SDM conversations and highlights some key areas for further research to advance SDM in the ED.
共同决策（SDM）已被倡导为一种在多种情况下选择医学检查和治疗方法的途径。共同决策的目标是确保患者充分知情，有意义地参与决策，并接受符合其目标和偏好的治疗。关于用于促进共同决策的工具（称为患者决策辅助工具），有大量证据，并且已经开发了许多不同的措施来评估共同决策的影响。然而，对于这些工具和措施在急诊科（ED）环境中的适用性，人们了解得相当少。本文基于在2016年学术急诊医学共识会议上发表的两场主题演讲中的见解，讨论了共同决策测量的科学现状以及促进共同决策对话的患者决策辅助工具的设计，并强调了一些关键领域，以便进一步开展研究，在急诊科推进共同决策。
