title: Shared Decision-Making in the Management of Congenital Vascular Malformations.
abstract: BACKGROUND
  In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters.
  
  
  METHODS
  In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making).
  
  
  RESULTS
  Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores.
  
  
  CONCLUSIONS
  Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Sophie E R
authors.initials: SER
authors.lastname: Horbach
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Dirk T
authors.initials: DT
authors.lastname: Ubbink
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Fabienne E
authors.initials: FE
authors.lastname: Stubenrouch
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Mark J W
authors.initials: MJW
authors.lastname: Koelemay
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Carine J M
authors.initials: CJM
authors.lastname: van der Vleuten
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Bas H
authors.initials: BH
authors.lastname: Verhoeven
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Jim A
authors.initials: JA
authors.lastname: Reekers
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schultze Kool
authors.affiliation: Amsterdam and Nijmegen, The Netherlands.|From the Department of Plastic, Reconstructive, and Hand Surgery, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Academic Medical Center; and the Department of Dermatology, the Department of Surgery, and the Department of Radiology, Division of Interventional Radiology, Radboud University Medical Center.
authors.forename: Chantal M A M
authors.initials: CMAM
authors.lastname: van der Horst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D003657:Decision Making; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057566:Self Report; D054079:Vascular Malformations / Q000628:therapy*; D055815:Young Adult