Shared Decision Making Can Help Save Lives In Patients With Chest Pain  

Chest pain is the second most common reason why people are rushed to emergency treatment centers in the US, accounting for over eight million annual visits. To safeguard the health of chest pain patients, scientists in this latest research compared the efficacy of shared decision making with standard care techniques and cardiac testing.

The results showed that shared decision making increased patient knowledge about possible risk factors, elevated patient engagement, and without endangering any lives decreased the rate of admission within observational metrics for cardiac testing.

Scientists made sure that a large number of participants took part in the study, as to remove any errors and to effectively utilize the diverse dataset available at their disposal. 898 adults aged greater than 17 took part in the study.

All 898 of these participants presented with a main complaint of chest pain and were being considered for admission to an observation unit for cardiac tests. 451 of them were randomly allocated to the shared decision making aid group and 447 were assigned randomly to normal care group. 361 emergency medical practitioners, which included emergency physicians, nurse practitioners and physician assistants took care of the patients.

The researchers noted patients’ knowledge about their condition, particularly the risks that their disease of acute coronary syndrome carried and potential treatment options that the patients could opt for. Secondary outcomes included involvement in the decision to be admitted, ratio of patients admitted for cardiac testing and the 30-day period of major adverse cardiac events.

Compared with the normal care group, patients in the decision aid group had more knowledge of their risk for acute coronary syndrome and treatment options that they could opt.

Moreover, those patients were more involved in the decision making process, compared with the normal care group, also those patients decided with their clinician to be admitted for cardiac testing less frequently, compared to the normal care group. Luckily, there were no extensive adverse cardiac events due to this intervention technique.

A study coordinator calculated the patient’s pretest odds of acute coronary syndrome in the shared decision making group. After properly evaluating the patient’s condition and the relevant ECG tests, the coordinator then used the decision aid to educate the patient about the results of the tests, any possible need for observation and further cardiac testing, need for any relevant tests to completely rule out acute myocardial infarction, should the need arise, and a personalized 45-day risk for acute coronary syndrome. The coordinator then assisted the patient in choosing the disease management option most suited to their condition and requirements.

Whereas the normal care group received instructions from a study coordinator according to the clinician’s usual feedback. The clinician did not have access to the shared decision making aid or the quantitative probability web tool that the other group had. Normal care was not standardized due to the nature of the study.

How Technology Is Shaping Shared Decision Making?

Shared decision making is the process of making healthcare decisions when both the patient and physician collaborate together. It heavily relies on using clinical data, presenting it to the patient in a manner that he can easily understand and comprehend, and also puts into consideration the patient’s preferences and requirements.

Much value lies in the fact that a decision may not necessarily be made on scientific and medical data alone, but may also involve, as an example, a patient choosing a less risky option, when there are more than one treatment options available. So it involves a lot of input from patients.

Individuals seeking treatment can not only feel relieved that the treatment they are about to receive is in accordance with their wishes, they can also feel empowered knowing that they have the option to make informed decisions with the advice and proper guidance of a qualified doctor.

More often than not patients do not have the knowledge to make proper informed decisions regarding the healthcare they are about to receive. Due to which it is vital that medical information is presented in an easy to understand manner. Here is where the technology comes in.

Shared decision making software can collect and analyze medical data more efficiently than ever before, this makes the decision making process easier as it can narrow down the choices in tandem to a user’s preference.

Moreover, these software programs can collect and manage user’s medical data over the years, and by using data mining and other data gathering techniques, these programs can advise more personalized and accurate treatment as a person’s preferences and requirements change with time.

As this study proved that shared decision making resolved potential decisional conflict, without affecting the patient-doctor relation, and also managed to decrease the rate of admission to an observation unit for advanced cardiac testing and cardiac stress testing, shared decision making is quite feasible in an actual real world scenario.

These results encourage medical facilities to pick up on this innovative technology and calls for healthcare policies and clinical protocols to allow for more transparency between doctor and patient. It encourages more patient involvement as it can tremendously cut down hospital errors thus minimizing patient fatality risk.

Despite its enormous potential, shared decision making faces an uphill battle, as many old fashioned and narrow minded policymakers might be skeptical to this technology and want things to continue the old fashioned way. Their doubt isn’t without warrant as there certainly is a risk of an adverse outcome when an unqualified person starts making decisions that require years of training. But as science continues to evolve at such a rapid rate, a time will come when this risk will be practically non-existent.

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