Lapides David A
Department of Neurology, University of Virginia, Charlottesville, VA.
Neurol Clin Pract. 2021 Apr;11(2):141-146. doi: 10.1212/CPJ.0000000000000796.
In this article, the author explores the use of shared decision making (SDM) in the management of the preference-sensitive condition, neural autoantibody-mediated syndromes.
The field of autoimmune neurology lacks trials and often data to support therapeutic decisions. Treatment choices need to be made acutely, lacking crucial laboratory information and with uncertainty regarding treatment response and prognosis. This lack of data does not necessitate indecision in a population where delayed treatment may lead to poor outcomes. Over the past several decades, SDM has emerged as a model of communication enabling clinicians and their patients to explore current knowledge in the context of a patient's values and goals to arrive at joint decision, even when data are lacking.
SDM is a tool autoimmune neurologists should use to develop individualized treatment plans based on the patient's clinical presentation contextualized within specific values and preferences.
在本文中，作者探讨了共同决策（SDM）在偏好敏感型疾病——神经自身抗体介导综合征管理中的应用。
自身免疫性神经病学领域缺乏试验，且常常缺乏支持治疗决策的数据。治疗选择需要在缺乏关键实验室信息、对治疗反应和预后存在不确定性的情况下迅速做出。尽管缺乏数据，但在延迟治疗可能导致不良后果的人群中，并不一定需要犹豫不决。在过去几十年中，共同决策已成为一种沟通模式，使临床医生及其患者能够在患者的价值观和目标背景下探索现有知识，从而达成共同决策，即使在缺乏数据的情况下也是如此。
共同决策是自身免疫性神经病学家应使用的一种工具，用于根据患者在特定价值观和偏好背景下的临床表现制定个性化治疗方案。
