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A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness.

Publication ,  Journal Article
Cox, CE; White, DB; Abernethy, AP
Published in: Am J Respir Crit Care Med
August 15, 2014

In the setting of a complex critical illness, preference-sensitive decision making-choosing between two or more reasonable treatment options-can be difficult for patients, families, and clinicians alike. A common challenge to making high-quality decisions in this setting is a lack of critical information access and sharing among participants. Decision aids-brochures, web applications, and videos-are a major focus of current research because mounting evidence suggests they can improve decision-making quality and enhance collaborative shared decision making. However, many decision aids have important limitations, including a relatively narrow capacity for personalization, an inability to gather and generate clinical data, a focus on only a single disease or treatment, and high developmental costs. To address these issues and to help guide future research, we propose a model of "universal" electronic decision support that can be easily adapted by clinicians and patients/families for whatever decision is at hand. In this scalable web-based platform, a general shared decision-making core structure would accommodate simple, interchangeable disease and treatment information modules. The format and content of the system could be adapted to decisional participants' unique characteristics, abilities, and needs. Universal decision support can better standardize a decisional approach and also allow a unique degree of personalization within a framework of shared decision making. We also discuss potential criticisms of this approach as well as strategies that can overcome them in a critical illness setting.

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Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

August 15, 2014

Volume

190

Issue

4

Start / End Page

366 / 373

Location

United States

Related Subject Headings

  • Respiratory System
  • Professional-Patient Relations
  • Patient-Centered Care
  • Patient Participation
  • Humans
  • Health Services Needs and Demand
  • Family
  • Decision Support Techniques
  • Decision Support Systems, Clinical
  • Critical Illness
 

Citation

APA
Chicago
ICMJE
MLA
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Cox, C. E., White, D. B., & Abernethy, A. P. (2014). A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness. Am J Respir Crit Care Med, 190(4), 366–373. https://doi.org/10.1164/rccm.201404-0728CP
Cox, Christopher E., Douglas B. White, and Amy P. Abernethy. “A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness.Am J Respir Crit Care Med 190, no. 4 (August 15, 2014): 366–73. https://doi.org/10.1164/rccm.201404-0728CP.
Cox, Christopher E., et al. “A universal decision support system. Addressing the decision-making needs of patients, families, and clinicians in the setting of critical illness.Am J Respir Crit Care Med, vol. 190, no. 4, Aug. 2014, pp. 366–73. Pubmed, doi:10.1164/rccm.201404-0728CP.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

August 15, 2014

Volume

190

Issue

4

Start / End Page

366 / 373

Location

United States

Related Subject Headings

  • Respiratory System
  • Professional-Patient Relations
  • Patient-Centered Care
  • Patient Participation
  • Humans
  • Health Services Needs and Demand
  • Family
  • Decision Support Techniques
  • Decision Support Systems, Clinical
  • Critical Illness