Douglas J Opel, Maya T Gerstein, Adam C Carle, Alaina K Fournier, Ian Hargraves, Jennifer E Lafata, Ellen A Lipstein, Trudy Mallinson, Nathalie Moise, Heather B Neuman, Mary Nix, Christina Papadimitriou, Laura Scherer, Karen Sepucha, Matthew Simpson, Alan Schwartz, Jennifer E Stevens-Lapsley, Neal W Dickert
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The Agency for Healthcare Research and Quality encouraged a re-examination of the concept, process, and measurement of shared decision-making (SDM) in 2016. Progress, however, has been slow. One illustrative example is SDM's relationship with the concept of equipoise: there remains little consensus on what equipoise means in the context of SDM, creating confusion about when SDM is and is not indicated. In this paper, we describe the ways in which this focus on equipoise in SDM is counter-productive and argue that equipoise is neither a necessary nor sufficient criterion in determining the need for SDM. Moreover, we suggest that what is needed to move the field of SDM forward is a shift away from focusing on when SDM is needed to instead focusing on how best to accomplish SDM across a variety of contexts by advancing the science of SDM implementation.
期刊介绍:
The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.