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Table 1 Characteristics of 74 included articles

From: Shared decision making in surgery: a scoping review of patient and surgeon preferences

Article and Date of Publication Study Population Acuity of the Intervention Major Findings Related to Decision Making (DM) Preferences DM Theme Related to Major Findingsa Factors Associated with Favoring SDM
Almyroudi et al. (2011) [17] 329 breast cancer patients Urgent 71.1% preferred a passive role; 24% a collaborative role;4.6% an active role SG Younger age, higher education
Ananian et al. (2004) [18] 181 breast cancer patients Elective 57% of women choosing breast reconstruction “decided with surgeon” 70% of these patients were satisfied with the information received. SDM Type of procedure
Andersen et al. (2009) [19] 636 breast cancer survivors Urgent On average, 72% reported being “very involved, I made all the decisions myself.” 80% were content with DM role. IDM Younger age, level of education, income
Asghari et al. (2008) [20] 299 hospitalized patients (85% on surgical wards) Unclear “strongly desire to receive information and participate in decision-making” SDM Female, level of education
Ashraf et al. (2013) [21] 465 patients undergoing either immediate or delayed breast reconstruction Elective 66% were in the “informed-consumerist” group when it came to actual DM. 86.3% of these patients were satisfied with the information received. IDM  
Avis (1994) [22] 20 hernia repair patients Elective “expectations of participation can be summarized as ‘being told’ and ‘going in to get it fixed’” SG  
Ballinger et al. (2008) [23] 131 breast cancer patients Urgent 61% “felt their healthcare professionals had surgical preferences for them, believed that clinical issues determined these preferences, but still knew the choice was theirs” SDM  
Beaver et al. (2005) [24] 41 colorectal cancer patients Urgent “wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions” SG  
Beaver et al. (2007) [25] 35 health professionals caring for colorectal cancer patients (4 were surgeons) Urgent “shared decision making was favored by health professionals” SDM Younger patient age
BeLue et al. (2004) [26] 50 cardiologists making a decision about surgery; 92 patients with coronary artery disease Urgent Physicians: 74% “prefer patients who actively participate in the decision;” Patients: 50% “prefer the physician to make the decision;” 40% SDM;” 10% “prefer to make the decision on their own” SG SDM  
Blumenthal-Barby et al. (2015) [27] 30 left ventricular assist device patients and candidates Urgent “deferred heavily to clinicians” SG  
Burton et al. (2017) [28] 101 older breast cancer patients Urgent 39% preferred “patient-centred;” 38% “doctor-centred;” 24% SDM SG/
Butow et al. (2007) [29] 135 patient advocates; 142 breast cancer surgeons Urgent 66% of surgeons and 62% of patient advocates preferred SDM SDM SDM  
Campesino et al. (2012) [30] 39 breast cancer survivors Urgent Spanish-speaking Latinas preferred “physician treatment recommendations;”
English-speaking Latinas and African-Americans preferred SDM
Cohen (2003) [31] 19 patients with localized prostate cancer Urgent Most viewed the surgeon-guided approach as “appropriate and welcome.” SG  
Corriere et al. (2015) [32] 81 patients undergoing elective vascular procedures Elective 93% preferred “choosing together with the provider;” 62% preferred “having the provider choose for them” SDM Multiple treatment options, type of procedure
Cuypers et al. (2016) [33] 562 prostate cancer survivors Urgent 59% preferred a collaborative role; 22% an active role; 19% a passive role SDM Higher education; younger age; higher SES
Doring et al. (2014) [34] 105 hand surgeons; 84 patients with trigger finger Elective Patients “preferred to decide for themselves”; surgeons preferred SDM IDM SDM  
Durif-Bruckert et al. (2015) [35] 146 breast cancer patients Urgent wanted to participate in decisions, but “perceived SDM as an obligation” because it did not seem to fit with their idea of a proper doctor-patient relationship SG Trust in surgeon; support from family; written information from surgeon
Gainer et al. (2017) [36] 15 frail and older patients; 20 care team members (includes surgeons) Unclear both patients and care team members “supported a formal approach” to SDM SDM SDM  
Ghane et al. (2014) [37] 380 general surgery patients Elective “preferred relatively high levels of decisional control on average
(M = 8.95 out of 10, SD = 2.15).”
IDM Male; good health; high health literacy
Golden et al. (2017) [38] 20 clinicians (7 were surgeons) Urgent Most felt that they practiced SDM, even though they did not tend to distinctly prompt patient DM preferences SDM  
Gong et al. (2011) [39] 78 patients with carpal tunnel syndrome Elective 76% preferred SDM SDM History of surgical procedure; importance of family member opinions; having private insurance
Hack et al. (2006) [40] 205 breast cancer patients Urgent 42% preferred a collaborative role; 35.6% an active role; 22.4% a passive role SDM Age < 70, non-widowed, longer duration post-op
Hageman et al. (2014) [41] 103 hand surgeons; 79 patients with carpal tunnel syndrome Elective Surgeons: 74% preferred “patient and provider make a shared decision;” Patients: 59% preferred that “the patient decides” IDM SDM  
Hawley et al. (2008) [42] 925 breast cancer patients Urgent Actual DM role: 37% SDM; 36% “patient-based;” 27% “surgeon-based.” Preferred DM role: 93% content with level of DM involvement SDM/
Heggland & Hausken (2013) [43, 44] 11 health professionals from 6 surgical wards; 7 patients who underwent surgical treatment Elective Health professionals: majority preferred a “shared” or “informed” model; Patients: about half preferred a “shared” or “informed” model and the other half preferred a “paternalistic” model SDM/
SDM Female
Heggland & Hausken (2014) [45] 7 surgical patients; 4 surgeons Elective/
Surgeons: the majority preferred an “informed model … patient is given information and left to make the decision;” Patients: 3 preferred a “paternalistic model” and 2 preferred shared. SG IDM  
Heggland et al. (2014) [44, 45] 119 physicians working in 6 surgical wards Unclear physicians on average rated decision-making control a 4.6, which means that “physicians were not reluctant to involve patients in decision-making processes” SDM  
Henderson & Shum (2003) [46] 49 surgical and medical patients Elective/
Where 1 = active role, 3 = shared, and 5 = passive – the mean DM value for the severe scenario was 3.55; moderate scenario was 3.37; mild scenario was 3.00 SDM Younger age, non-critical condition
Henderson et al. (2006) [47] 186 inpatients in two surgical units Unclear “females indicated that they would like to have more input in the decision-making process than the males” (3.57 v. 3.81 on the Controlled Preferences Scale) SDM Female; higher education
Hopmans et al. (2015) [48] 87 lung cancer patients Urgent “guidance by the clinician” was identified as most important; “active role of patient in treatment decision making” regarded as less important SG  
Hou et al. (2014) [49] 113 colorectal cancer patients Urgent 41.6% preferred a passive role; 24.8% SDM; 7.1% an active role SG Female; no stoma
Iaccarino et al. (2017) [50] 428 clinician members of the American Thoracic Society Urgent Perceived Role: 50.4% “share decisions equally with the patient”; 34.5% “allow the patient to decide;” 15.1% “decide for themselves after considering the patient’s opinion” SDM More years in practice; more comfort in pulmonary nodule management
Ihrig et al. (2011) [51] 31 prostate cancer patients Urgent “most patients wanted to decide on their treatment options together with their physician” SDM  
Janz et al. (2004) [52] 101 breast cancer patients Urgent 47% preferred SDM; 38% preferred to make the decision “with physician input” SDM College degree; higher self-efficacy
Johnson et al. (1996) [53] 76 newly diagnosed breast cancer patients Urgent “74% wanted their surgeons to make a recommendation and when given, 94% followed the recommended treatment plan” SG  
Keating et al. (2002) [54] 1081 breast cancer patients Urgent 64% preferred a collaborative role SDM  
Keating et al. (2010) [55] 5383 lung or colorectal cancer patients Urgent 38.9% = “patient controlled,” 43.6% = SDM; 17.5% = “physician controlled” SDM Married, better pre-diagnosis health status, Caucasian, strong evidence for procedure
Lally (2009) [56] 18 breast cancer patients Urgent “women’s lack of sharing their preferences with their surgeons and the surgeons’ lack of making treatment recommendations resulted in what was more likely informed than shared decision making” IDM  
Lam et al. (2003) [57] 154 breast cancer patients Urgent 59% preferred SDM; 33% preferred “the choice to be their own;” 8% preferred “to delegate the decision” SDM Younger age
Lantz et al. (2005) [58] 1633 breast cancer patients Urgent Actual Role: 36.9% SDM; 37.9% made decision with “surgeon input.” 69% were satisfied with DM level. SDM  
Larsson et al. (1989) [59] 666 patients scheduled for invasive surgery Elective Actual DM: 41% “joint patient-doctor decision;” 29% “doctor advocated;” 8% “patient asked.” Preferred DM: 73% content with level of DM involvement SDM Female
Lee et al. (2012) [60] 82 patients with early gastric cancer Urgent The surgical group showed a more passive role in both their preferred and actual DM role SG  
Markovic et al. (2006) [61] 30 newly diagnosed gynecologic cancer patients Urgent “surgeon’s recommendation
and fear of dying from cancer” played the most important role in DM
Martinez et al. (2016) [62] 1690 newly diagnosed breast cancer patients Urgent In surgery, 51% preferred a “directive” communication style; 49% a “non-directive” communication style SDM/ SG   
McGuire et al. (2005) [63] 18 surgeons Unclear “Many physicians saw their role as an expert who educates the patient but retains control over the decision-making process;
others took a more collaborative approach, encouraging patients to assume decisional priority”
Multiple treatment options, increased risk, impact of procedure on patient lifestyle, moral content
Mendick et al. (2010) [64] 20 breast cancer patients; 8 surgeons Urgent Surgeons: “made most decisions for patients;” Patients: “generally lacked trust in their own decisions and usually sought surgeons’ guidance” SG SG Patients: strong evidence for procedure; Surgeons: multiple treatment options, impact of procedure on patient lifestyle
Meredith (1993) [65] 30 surgical patients; 14 surgeons Unclear Patients: “majority agreed that the surgeon should supply them with the ‘pros’ and ‘cons’ of all measures to address the problem, and it was for them ultimately to decide what was right for them;” Surgeons: “not enthusiastic at the prospect of devoting more time to discussing surgical alternatives, risks and complications, and outlook indicators for their patients benefit” SDM SG  
Morgan et al. (2015) [66] 729 older breast cancer patients Urgent In surgery, 41.6% preferred SDM; 34.7% a “doctor-centered” approach; “23.7% a “patient-centered” approach SDM Older age
Morishige et al. (2017) [67] 1035 patients with irritable bowel disease Elective 56% “thought having a physician involve them in the decisions concerning their treatment was very important” SDM Comorbidities, surgical history; use of biologics, treated at an academic hospital, being married
Moumjid et al. (2003) [68] 22 breast cancer patients Urgent most were satisfied with the information given and the possibility of participating to the treatment decision-making process” SDM  
Nam et al. (2014) [69] 85 patients with carpal tunnel syndrome Elective “I prefer that my doctor and I share responsibility” = 29%; ““I prefer that my doctor makes the final decision about which treatment will be used but seriously considers my opinion = 35% SDM  
Omar et al. (2016) [70] 100 consecutive patients being seen in a multi-disciplinary stone clinic Elective 85% “would rely on the physician’s recommendation” SG  
Op den Dries et al. (2014) [71] 219 liver transplant candidates and recipients Urgent “79.8% wished to be involved in making the decision to accept or not accept a liver for transplantation” SDM  
Orsino et al. (2003) [72] 197 end stage renal disease patients Elective 41.5% preferred “equal responsibility;” 34.5% an “autonomous” role; 23.9% a decision driven by the health care team SDM Younger age
Pieterse et al. (2008) [73] 70 rectal cancer patients; 25 surgical oncologists Urgent The majority of patients and clinicians preferred SDM. SDM SDM Patients: Female, higher education
Ramfelt et al. (2005) [74] 55 rectal or colon cancer patients Urgent 71% of rectal cancer patients & 75% of colon cancer patients preferred a collaborative role SDM Younger age
Ratsep et al. (2014) [75] 150 patients with lumbar disc herniation Elective 47% preferred SDM SDM Desire for more disease specific information
Salkeld et al. (2004) [76] 175 rectal or colon cancer patients Urgent 54% preferred a surgeon-guided approach; 29% SDM; 15% a more independent DM role SG Female, younger age, history of radiation
Santema et al. (2017) [77] 67 patients with either abdominal aortic aneurysm or peripheral arterial occlusive disease Elective 58% preferred SDM SDM Trust in doctor, doctor has a clear communication style, doctor listens, enough time for consultation
Seror et al. (2013) [78] 415 young breast cancer patients Urgent Preferred a more passive approach (20.7% preferred “fully passive” and 36.4% preferred fairly passive) SG  
Sidana et al. (2012) [79] 488 young prostate cancer patients Urgent 52.3% preferred SDM; 45.8% an “informed decision made by myself based on information”; 2% a passive role SDM Higher education, type of procedure
Snijders et al. (2014) [80] 103 GI surgeons Urgent “most patients were offered only one treatment option and little SDM was seen” SG  
Stiggelbout & Kiebert (1997) [81] 52 cancer patients; 48 surgical patients Unclear “the physician should make the decisions, but strongly consider my opinion” was selected most frequently SG Younger age, female
Sung et al. (2010) [82] 93 patients with pelvic floor disorder Elective 47% preferred a collaborative role; 44% an active role; 9% a passive role SDM  
Tyler Ellis et al. (2016) [83] 154 newly diagnosed rectal cancer patients Urgent 43% of total mesorectal excision patients and 44% of local excision patients preferred SDM SDM Higher education, younger age
Uldry et al. (2013) [84] 253 patients undergoing elective GI surgery Elective 64% preferred an active role IDM   Younger age, male, level of education
Vogel et al. (2008) [85] 137 breast cancer patients Urgent 40.2% preferred a passive role; 30.6% an active role; 29.2% SDM SG Higher anxiety scores; multiple treatment options
Wang et al. (2018) [86] 154 breast cancer patients Urgent 55.2% preferred a collaborative role; 27.5% a passive role; 17.5% an active role SDM  
Weiner & Essis (2006) [87] 100 spine clinic patients Elective “the majority of patients felt that the physician, rather than the patient, should make the basic treatment decision” SG  
Wilson et al. (2017) [88] 157 patients undergoing major thoracic/abdominal operations Urgent 65.4% preferred a “patient-driven” role; 28.8% SDM; 5.8% a “surgeon-driven” role IDM  
Woltz et al. (2017) [89] 50 patients with displaced midshaft clavicular fracture Elective 36% preferred SDM; 34% “autonomous” role; 30% a passive role SDM  
Ziebland et al. (2006) [90] 43 ovarian cancer patients Urgent “preferred their medical team to decide on their behalf” or “‘going along with’ their doctor’s recommendation” SG  
  1. aDecision Making Preference: DM decision making, SG surgeon-guided, SDM shared decision making, IDM independent decision making
  2. ^Dx Diagnosis, Pt Patient, Surg Surgeon