Wouter Leclercq

ABSTRACT Introduction Shared decision making (SDM) and surgical informed consent (SIC) are increasingly recognized as important aspects of preoperative consultation in general surgery. Different perspectives of physicians and patients may result in suboptimal levels of communication, expectations and knowledge exchange . Goal of this study is to assess the quality of, and relation between, SDM and SIC in a general surgery outpatient department. Methods Randomly selected surgical patients completed a questionnaire concerning SDM aspects of their preoperative consultation (SDM-Q-9). Their surgeons completed the doctor’s version termed SDM-Q-Doc. SDM-Q-9 and SDM-Q-Doc scores (0-100), and SIC scores based upon the medical record (0-10) were calculated and analysed using standard statistical methods, including calculation of intraclass correlation coefficients (ICC). Results A total of 38 sets of both SDM-Q-9 and SDM-Q-Doc questionnaires were available for analysis. Median total SDM-Q-9 scores were higher than SDM-Q-Doc scores (90 vs. 79, P<0.05). Significant differences were found in 3 of 9 items of the patient’s and surgeon’s SDM questionnaires. SIC scores were low (4.1±1.3). Correlations between SDM-Q-9, SDM-Q-Doc and SIC scores were low (all ICCs <0.1). Discussion This pilot studying both shared decision making (SDM) and informed consent (SIC) in a surgical outpatient department indicates an imbalance in expectations between surgical patients, their surgeons and consent recordings. Future initiatives should be aimed at reducing this imbalance to optimize the physician-patient relationship with respect to legal standards.