A brief summary of the main projects conducted by the Health Decision Sciences Center at Massachusetts General Hospital.
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HDSC investigators are conducting research in three main areas:
The team is leading efforts to develop surveys to measure the quality of decisions for a range of common medical conditions, such as treatment of hip and knee osteoarthritis, breast cancer, and prostate cancer screening. The Decision Quality Instruments (DQIs) measure the extent to which the patient is informed, meaningfully involved in decision making, and receive treatment that matched their goals.
Shared Decision Making (SDM) is an interactive process that draws on the expertise of patients, healthcare providers, and the best availible clinical evidence to select the right medical test or treatment for each patient. Patient decision aids (PtDAs) have been studied in more than 100 randomized control studies and have been shown to inform and engage patients in decisions about their health care.
We have designed, conducted, and evaluated a series of training sessions for senior clinicians, staff, residents, and medical students to advance shared decision making skills. The sessions focus on different aspects, such as how to communicate risks without confusing patients, how to elicit patients' goals and preferences in the constraints of a visit, and how to use decision aids and other tools to support patient-centered care. We actively seek out the best available tools and resources (such as patient decision aids) for our providers to use, and develop our own tools to meet specific needs of our patients and providers.
Here are some of the research projects currently underway at HDSC:
Improving Quality of Surgery Decisions in Orthopedics
With funding from the Gordon and Betty Moore Foundation, we have launched a study to improve patient engagement in decisions about elective surgery for hip or knee osteoarthritis, herniated disc or spinal stenosis.
We are conducting a longitudinal prospective cohort study to evaluate the impact of an enhanced information technology tool on the timely and reliable delivery of patient decision aids, and then determine the impact of the use of decision aids on the quality of decisions, treatment utilization and the quality of care.
Managing Expectations for Acute Low Back Pain Study (MAPS)
The HDSC and the MGH back pain care redesign team received a Clinical Innovation Award to examine shared decision making in the management of acute low back pain (ALBP) with two urgent care clinics. Typically, SDM has not been seen as something relevant for urgent care settings and this project expands our understanding of the role that decision aids delivered at the point of care have on patients' expectations, health outcomes and use of services.