Wouter Leclercq

Chapter 7 112 The process of SIC was recorded in the EPD. For the purpose of the study, a total of ten items, deemed essential for SIC as previously described, were scored by the first author as listed in Table 7.2. 2 As a consequence, SIC scores ranged from 0 (no item discussed) to 10 points (all items discussed). Table 7.1 SDM-Q-9 and SDM-Q-Doc items (Santema 4 ). SDM Item 1 Clarifying a decision needs to be made Item 2 Eliciting the patients’ preferred involvement Item 3 Stating there is more than one way to deal with the problem Item 4 Explaining pros and cons of the treatment options Item 5 Investigating if the patient understood all the information Item 6 Identifying the patients’ preferred treatment option Item 7 Weighting the treatment options Item 8 Making a shared decision Item 9 Agreement on follow up arrangement Apart from multiple Choice Questions, the SDM-Q-9 and –Doc consisted of two open questions: “What is the reason for consultation?” and “Which decision is made?”. SDM = Shared Decision Making. Table 7.2 Electronic Patient file SIC items and surgeon scores. SIC % Item 1 Patient competence is checked 0 Item 2 Diagnosis is noted 91 Item 3 Prognosis with or without surgery is noted 19 Item 4 Advised treatment is noted 100 Item 5 Alternative options are noted 72 Item 6 Frequent complications are noted 81 Item 7 Infrequent but serious complications are noted 53 Item 8 Leaflet is provided 3 Item 9 Operating surgeon is clearly appointed 3 Item 10 Explicit consent patient is noted 6 %= Percentage of dossiers where the specific SIC item was scored. Calculations and statistics It was decided to obtain data sets of approximately 30 patient-surgeon-interactions as a pilot sample. A power analysis could not be performed as previous data on this issue were not available. Goal of the pilot was to obtain SDM-Q-9, SDM-Q-Doc and SIC scores for analysis. Primary focus was to collect baseline outcome data for these three scores and to identify a correlation between SDM and SIC scores.