title: Shared Decision Making in Vascular Surgery: An Exploratory Study.
abstract: OBJECTIVE
  Shared decision making (SDM) is a process in which patients and their doctors collaborate in choosing a suitable treatment option by incorporating patient values and preferences, as well as the best available evidence. Particularly in vascular surgery, several conditions seem suitable for SDM because there are multiple treatment options. The objective of this study was to assess the degree of SDM behaviour in vascular surgery.
  
  
  METHODS
  Vascular surgeons of four Dutch hospitals selected consultations with patients who were facing a treatment decision. Immediately after the consultation, patients and surgeons completed the (subjective) SDM Q-9 and SDM Q-doc questionnaires respectively, to appreciate the perceived level of SDM behaviour. Two evaluators independently and objectively rated SDM behaviour in the audiotaped consultations, using the Observing Patient Involvement (OPTION-12) scale.
  
  
  RESULTS
  Nine vascular surgeons and three vascular surgeons in training conducted 54 consultations. The patients' median SDM Q-9 score was high, 93% (IQR 79-100%), and 16/54 (29.6%) of them gave the maximum score. The surgeons' median score was also high, 84% (IQR 73-92%), while 4/54 (7.4%) gave the maximum score. In contrast, mean OPTION score was 31% (SD 11%). Surgeons hardly ever asked the patients for their preferred approach to receive information, whether they had understood the provided information, and how they would like to be involved in SDM.
  
  
  CONCLUSIONS
  Currently, objective SDM behaviour among vascular surgeons is limited, even though the presented disorders allow for SDM. Hence, SDM in vascular surgical consultations could be improved by increasing the patients' and surgeons' awareness and knowledge about the concept of SDM.
authors: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: t.b.santema@amc.uva.nl.
authors: T B
authors: TB
authors: Santema
authors: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors: F E
authors: FE
authors: Stubenrouch
authors: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors: M J W
authors: MJ
authors: Koelemay
authors: Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors: A C
authors: AC
authors: Vahl
authors: Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors: C F W
authors: CF
authors: Vermeulen
authors: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors: M J T
authors: MJ
authors: Visser
authors: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors: D T
authors: DT
authors: Ubbink
mesh_terms: D001291:Attitude of Health Personnel; D001364:Awareness; D002755:Choice Behavior; D003142:Communication; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009426:Netherlands; D010358:Patient Participation; D010465:Perception; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D066231:Surgeons / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects
keywords: Informed consent; Physician–patient relations; Shared decision making; Vascular surgery