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Objective: To assess how informed patients are about breast reconstruction, and how involved they are in decision making. Summary Background Data: Breast reconstruction is an important treatment option for patients undergoing mastectomy. Wide variations in who gets reconstruction, however, have led to concerns about decision making. Methods: We conducted a prospective cross-sectional study of patients planning mastectomy at a single site, over 20 months. Before surgery, patients completed a survey with validated scales to assess knowledge about breast reconstruction and involvement in decision making. Factors associated with knowledge were examined in a multivariable linear regression model. Results: A total of 145 patients enrolled (77% enrollment rate), and 126 remained eligible. The overall knowledge score was 58.5% (out of 100%). Knowledge about risk of complications was especially low at 14.3%. Knowledge did not differ by treatment (reconstruction or not). On multivariable analysis, non-white race was independently associated with lower knowledge. Most patients (92.1%) reported some discussion with a provider about reconstruction, and most (90.4%) reported being asked their preference. More patients reported discussing the advantages of reconstruction (57.9%) than the disadvantages (27.8%). Conclusions: Women undergoing mastectomy in this sample were highly involved in decision making, but had major deficits in knowledge about the procedure. Knowledge about the risk of complications was particularly low. Providers seemed to have discussed the advantages of reconstruction more than its disadvantages. [ABSTRACT FROM AUTHOR]

The article discusses a research study which aimed to evaluate the performance of herniated disc-decision quality instrument (HD-DQI) in measuring the quality of decisions about treatment of herniated disc. A background is provided involving clinical practice guidelines issued by the American Pain Society. Methods used are presented involving study samples, and the psychometric analyses. Results are explained indicating that HD-DQI met several criteria for patient-reported survey instrument.

The author discusses preference-sensitive decision, the kind of medical decision that is dependent on whether the test or treatment is clinically appropriate and reflects patient's informed goals and preferences. He says that shared decision-making is an example of an approach that will ensure the involvement of patients in deciding on particular treatments whenever possible. Patient decision aids are tools designed to support the approach by matching the right patient to the right treatment.

Objective: To assess how informed patients are about breast reconstruction, and how involved they are in decision making., Summary Background Data: Breast reconstruction is an important treatment option for patients undergoing mastectomy. Wide variations in who gets reconstruction, however, have led to concerns about decision making., Methods: We conducted a prospective cross-sectional study of patients planning mastectomy at a single site, over 20 months. Before surgery, patients completed a survey with validated scales to assess knowledge about breast reconstruction and involvement in decision making. Factors associated with knowledge were examined in a multivariable linear regression model., Results: A total of 145 patients enrolled (77% enrollment rate), and 126 remained eligible. The overall knowledge score was 58.5% (out of 100%). Knowledge about risk of complications was especially low at 14.3%. Knowledge did not differ by treatment (reconstruction or not). On multivariable analysis, non-white race was independently associated with lower knowledge. Most patients (92.1%) reported some discussion with a provider about reconstruction, and most (90.4%) reported being asked their preference. More patients reported discussing the advantages of reconstruction (57.9%) than the disadvantages (27.8%)., Conclusions: Women undergoing mastectomy in this sample were highly involved in decision making, but had major deficits in knowledge about the procedure. Knowledge about the risk of complications was particularly low. Providers seemed to have discussed the advantages of reconstruction more than its disadvantages.