Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/31248 http://dx.doi.org/10.1002/art.24368 |
Resumo: | Objective. Decision boards (DBs) help clinicians present options and include patients in the decision-making process. Our objective was to describe the steps to develop a DB to support shared decision making and assess reliability and construct validity.Methods. Systemic lupus erythematosus (SLE) scenarios were designed with the support of experts for disease severity, potential side effects, and outcomes. the DB comprised clinical information, 2 different treatment options (oral and intravenous), a description of the potential to control SLE within 5 years, and a list of potential side effects. Patients selected what they thought would be the 3 worst side effects and were informed of the probability that these would occur. We presented the DB to 172 patients who were asked to select and justify 1 treatment option. Reliability was assessed by kappa statistics. Construct validity was tested by an a priori hypothesis, analyzing the correlation between treatment decision and side effects selected, self-assessment score, educational level, and clinical aspects.Results. Patients favored oral medication, and side effects most often listed were iatrogenic cancer (44.2%), hair loss (21.6%), and severe infection (19.1%). justifications were risk (48.9%), practicality (36.6%), effectiveness (12.2%), and risk-benefit tradeoff (2.3%). Reliability was similar to that found in the test phase (kappa = 0.689, P < 0.001). Validity was tested by prediction of treatment decision based on the undesirable side effects selected (P = 0.047). DB content was clear and easy for all patients to understand (P = 0.05). Immunosuppressive drugs influenced patient decisions (P = 0.006).Conclusion. DB is a reliable and valid instrument to assess SLE patient preference. |
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Abreu, Mirhelen Mendes de [UNIFESP]Gafni, AmiranFerraz, Marcos Bosi [UNIFESP]Universidade Federal de São Paulo (UNIFESP)McMaster Univ2016-01-24T13:52:11Z2016-01-24T13:52:11Z2009-01-15Arthritis & Rheumatism-arthritis Care & Research. Hoboken: Wiley-liss, v. 61, n. 1, p. 37-45, 2009.0004-3591http://repositorio.unifesp.br/handle/11600/31248http://dx.doi.org/10.1002/art.2436810.1002/art.24368WOS:000262420300006Objective. Decision boards (DBs) help clinicians present options and include patients in the decision-making process. Our objective was to describe the steps to develop a DB to support shared decision making and assess reliability and construct validity.Methods. Systemic lupus erythematosus (SLE) scenarios were designed with the support of experts for disease severity, potential side effects, and outcomes. the DB comprised clinical information, 2 different treatment options (oral and intravenous), a description of the potential to control SLE within 5 years, and a list of potential side effects. Patients selected what they thought would be the 3 worst side effects and were informed of the probability that these would occur. We presented the DB to 172 patients who were asked to select and justify 1 treatment option. Reliability was assessed by kappa statistics. Construct validity was tested by an a priori hypothesis, analyzing the correlation between treatment decision and side effects selected, self-assessment score, educational level, and clinical aspects.Results. Patients favored oral medication, and side effects most often listed were iatrogenic cancer (44.2%), hair loss (21.6%), and severe infection (19.1%). justifications were risk (48.9%), practicality (36.6%), effectiveness (12.2%), and risk-benefit tradeoff (2.3%). Reliability was similar to that found in the test phase (kappa = 0.689, P < 0.001). Validity was tested by prediction of treatment decision based on the undesirable side effects selected (P = 0.047). DB content was clear and easy for all patients to understand (P = 0.05). Immunosuppressive drugs influenced patient decisions (P = 0.006).Conclusion. DB is a reliable and valid instrument to assess SLE patient preference.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, São Paulo, BrazilMcMaster Univ, Hamilton, ON, CanadaUniversidade Federal de São Paulo, EPM, São Paulo, BrazilWeb of Science37-45engWiley-BlackwellArthritis & Rheumatism-arthritis Care & Researchhttp://olabout.wiley.com/WileyCDA/Section/id-406071.htmlinfo:eu-repo/semantics/openAccessDevelopment and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/312482022-11-03 15:00:25.947metadata only accessoai:repositorio.unifesp.br:11600/31248Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-11-03T18:00:25Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
title |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
spellingShingle |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil Abreu, Mirhelen Mendes de [UNIFESP] |
title_short |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
title_full |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
title_fullStr |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
title_full_unstemmed |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
title_sort |
Development and Testing of a Decision Board to Help Clinicians Present Treatment Options to Lupus Nephritis Patients in Brazil |
author |
Abreu, Mirhelen Mendes de [UNIFESP] |
author_facet |
Abreu, Mirhelen Mendes de [UNIFESP] Gafni, Amiran Ferraz, Marcos Bosi [UNIFESP] |
author_role |
author |
author2 |
Gafni, Amiran Ferraz, Marcos Bosi [UNIFESP] |
author2_role |
author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) McMaster Univ |
dc.contributor.author.fl_str_mv |
Abreu, Mirhelen Mendes de [UNIFESP] Gafni, Amiran Ferraz, Marcos Bosi [UNIFESP] |
description |
Objective. Decision boards (DBs) help clinicians present options and include patients in the decision-making process. Our objective was to describe the steps to develop a DB to support shared decision making and assess reliability and construct validity.Methods. Systemic lupus erythematosus (SLE) scenarios were designed with the support of experts for disease severity, potential side effects, and outcomes. the DB comprised clinical information, 2 different treatment options (oral and intravenous), a description of the potential to control SLE within 5 years, and a list of potential side effects. Patients selected what they thought would be the 3 worst side effects and were informed of the probability that these would occur. We presented the DB to 172 patients who were asked to select and justify 1 treatment option. Reliability was assessed by kappa statistics. Construct validity was tested by an a priori hypothesis, analyzing the correlation between treatment decision and side effects selected, self-assessment score, educational level, and clinical aspects.Results. Patients favored oral medication, and side effects most often listed were iatrogenic cancer (44.2%), hair loss (21.6%), and severe infection (19.1%). justifications were risk (48.9%), practicality (36.6%), effectiveness (12.2%), and risk-benefit tradeoff (2.3%). Reliability was similar to that found in the test phase (kappa = 0.689, P < 0.001). Validity was tested by prediction of treatment decision based on the undesirable side effects selected (P = 0.047). DB content was clear and easy for all patients to understand (P = 0.05). Immunosuppressive drugs influenced patient decisions (P = 0.006).Conclusion. DB is a reliable and valid instrument to assess SLE patient preference. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-01-15 |
dc.date.accessioned.fl_str_mv |
2016-01-24T13:52:11Z |
dc.date.available.fl_str_mv |
2016-01-24T13:52:11Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Arthritis & Rheumatism-arthritis Care & Research. Hoboken: Wiley-liss, v. 61, n. 1, p. 37-45, 2009. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/31248 http://dx.doi.org/10.1002/art.24368 |
dc.identifier.issn.none.fl_str_mv |
0004-3591 |
dc.identifier.doi.none.fl_str_mv |
10.1002/art.24368 |
dc.identifier.wos.none.fl_str_mv |
WOS:000262420300006 |
identifier_str_mv |
Arthritis & Rheumatism-arthritis Care & Research. Hoboken: Wiley-liss, v. 61, n. 1, p. 37-45, 2009. 0004-3591 10.1002/art.24368 WOS:000262420300006 |
url |
http://repositorio.unifesp.br/handle/11600/31248 http://dx.doi.org/10.1002/art.24368 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Arthritis & Rheumatism-arthritis Care & Research |
dc.rights.driver.fl_str_mv |
http://olabout.wiley.com/WileyCDA/Section/id-406071.html info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://olabout.wiley.com/WileyCDA/Section/id-406071.html |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
37-45 |
dc.publisher.none.fl_str_mv |
Wiley-Blackwell |
publisher.none.fl_str_mv |
Wiley-Blackwell |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1802764179686293504 |