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Master Thesis

Les recommandations de bonne pratique clinique francophones favorisent-elles la prise de décision partagée ? -Élaboration d’un outil d’évaluation par méthode Delphi®

Abstract : Introduction: modern medical practice relies on two main concepts: evidence-based medicine (EBM), for its scientific approach, and shared decision making (SDM), as a way to optimize health care through the patient doctor relationship. Where clinical practice guidelines (CPG) have made their way into daily practice as an operational form of EBM, shared decision making is struggling to settle in. It appears that CPGs do not encourage shared decision making but there is no tool to verify it. Using the Delphi Method, we translated and converted strategies put forward in How can CPGs be adapted to facilitate SDM into a French appraisal tool that could quantify SDM in CPGs. Method: three rounds of online questionnaires enabled 7 international SDM experts from the FREeDOM collaboration to reach consensus for the translation, pertinence and adjustment of these 19 strategies into assessment criteria. Results: the 17 criteria produced include general strategies such as adding a specific chapter on SDM, using wording that makes patient involvement explicit, presenting outcomes, benefits and harms of all options including “doing nothing”; as well as recommendation-specific strategies such as giving the patient a copy of his individualized treatment plan, recommending which patient decision aid should be used and when, or encouraging the patient to engage a proxy for the deliberation. Conclusion: by assessing whether a CPG facilitates SDM, this appraisal tool could help bridge the gap between EBM and patient-centered medicine. It will need to be tested for ease of use, pertinence and reproducibility.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03380200
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Submitted on : Friday, October 15, 2021 - 12:44:50 PM
Last modification on : Thursday, November 25, 2021 - 3:15:46 AM

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  • HAL Id : dumas-03380200, version 1

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Aliénor Daron-Lefebvre, Pauline Panek. Les recommandations de bonne pratique clinique francophones favorisent-elles la prise de décision partagée ? -Élaboration d’un outil d’évaluation par méthode Delphi®. Médecine humaine et pathologie. 2021. ⟨dumas-03380200⟩

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