Makkar Dheeraj, Sauhta Ravi, Jaganmohan Surekha, Priyadarshini T, Devanand Viji, Raja Ashwini
Orthopaedic Oncology Fellow, Emory University, Atlanta, 30307, GA, USA.
Department of Joint Replacement and Orthopaedics, Artemis Hospital, Gurgaon, 122001, Haryana, India.
J Clin Orthop Trauma. 2025 Mar 27;65:102989. doi: 10.1016/j.jcot.2025.102989. eCollection 2025 Jun.
The shift from a paternalistic model to a patient-centered approach in medical decision-making has significantly transformed the doctor-patient relationship, especially in India. The rise of the Internet and patient education resources has empowered patients to actively participate in their healthcare decisions.
A systematic review was registered in PROSPERO [CRD420250652673] and was conducted using PubMed, Scopus, Web of Science (WoS), and Google Scholar, focusing on English-language publications about shared decision-making (SDM) in total joint replacement. Randomized controlled trials, studies on decision-making preferences, and disease-specific decision aids were included. Exclusion criteria encompassed advance directives and lifestyle-related decisions.
SDM models have gained prominence globally, with various nations integrating patient rights and decision-making tools into their healthcare systems. Different patient care models, including paternalistic, informed, and SDM, have been critically examined for their advantages and limitations.
The review highlights the evolving nature of patient involvement in medical decisions, emphasizing the importance of SDM in aligning treatments with patient preferences and values.
在医疗决策中，从家长式模式向以患者为中心的方法转变显著改变了医患关系，尤其是在印度。互联网和患者教育资源的兴起使患者有能力积极参与自身的医疗保健决策。
一项系统评价在PROSPERO[CRD420250652673]上注册，并通过PubMed、Scopus、科学网（WoS）和谷歌学术进行，重点关注关于全关节置换中共同决策（SDM）的英文出版物。纳入了随机对照试验、决策偏好研究和特定疾病的决策辅助工具。排除标准包括预先指示和与生活方式相关的决策。
SDM模式在全球范围内日益突出，各国将患者权利和决策工具纳入其医疗保健系统。不同的患者护理模式，包括家长式、知情式和SDM模式，已因其优点和局限性而受到严格审视。
该综述强调了患者参与医疗决策的不断演变的性质，强调了SDM在使治疗与患者偏好和价值观相一致方面的重要性。
