A shared and personalized decision-making in pre-surgical consultations of brain tumor patients and neurosurgeons

Iris Bras, Margriet Sitskoorn, Ingrid van Vugt, Margot Joosen, Petra Hoogendoorn, Geert-Jan Rutten, Karin Gehring

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Abstract

Background
In order to assess whether the oncological benefits outweigh the functional risks of treatment for an individual patient, it is important that physicians involve patients in decision-making and personalize the process. This is especially important for brain tumor patients considering the limited treatment options available. The aim of this study is to evaluate shared decision-making and the personalization of the decision-making process during consultations of brain tumor patients and their neurosurgeons.

Material and Methods
For this observational study we collected 66 audio-recordings of pre-surgical consultations of adult brain tumor patients (glioma, meningioma) and their neurosurgeons. A preliminary analysis based on a shared decision-making template was conducted on 14/66 transcribed audio-recordings to assess in how many consultations the following key elements of shared decision-making were present, namely 1) offering a choice to the patient and emphasizing that the patient’s perspective is important in making the decision, 2) discussing treatment options with benefits and risks and 3) asking about treatment preferences and personal goals. Next, thematic analysis will be performed by two independent researchers until data saturation is reached to gain insight into personalization of the decision-making process as an integral part of shared decision-making.

Results
Preliminary findings show that 1) offering the patient a choice and emphasizing that the perspective of the patient is important in decisions was done in 12/14 consultations; 2) discussing treatment options with benefits and risks was present in every consultation (14/14); and 3) in 12/14 consultations the neurosurgeon asked the patient about his or her treatment preference. However, explicitly asking the patient about personal goals occurred only in 3/14 consultations. By the time of the conference, we expect to have explored the decision-making process more in-depth and will be able to share the themes we have identified related to personalization of the decision-making process.

Conclusion
Key elements of shared decision-making were present in most pre-surgical consultations, except for asking patients about their personal goals. Discussing personal goals that patients have concerning daily life may facilitate personalization of the decision-making process.
Original languageEnglish
Pages (from-to)ii71-ii71
JournalNeuro-Oncology
Volume24
Issue numberSuppl 2
DOIs
Publication statusPublished - 2022

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