Type of Publication: Journal Articles
Authors: Itay.Segal , Yuval Shahar
Title: A distributed system for support and explanation of shared decision-making in the prenatal testing domain.
ConferenceName: Journal of biomedical informatics
Name of the Journal: Journal of biomedical informatics
Year: 2009
Volume: 42
Issue: 2
Pages: 272-286
Abstract: Medical domains involve numerous tests and treatments, the sheer variety of which confounds both care providers and patients. Many of the decisions depend on the patient's preferences. Shared decision-making, which explicitly involves the patients and their preferences, is therefore imperative, but requires also a sufficient explanatory infrastructure. We introduce a distributed application, PANDEX, that, by using decision-analytic methods, assists patients and care providers to reach optimal decisions. Based on a generic architecture, the PANDEX prototype, which focuses on the domain of genetic prenatal consultation, is designed to calculate the optimal treatment strategy based on the patient's clinical data and preferences. A major focus of our study was on developing several types of in-depth sensitivity and importance analysis methods and on the implementation of the respective graphical tools embedded in the system, to help the patient fully understand the recommended strategy. A preliminary assessment of PANDEX by six genetic consultants demonstrated a relative unwillingness to work with PANDEX (mean=2.16+/-0.98 (SD), on a scale of 1-5), but a tendency to agree with its recommended strategies (mean=3.48+/-1.4) and with its capability to provide insights into the recommended strategies (3.28+/-1.23). PANDEX was considered by the consultants to be a potentially useful tool for patients.
Keywords: Decision Analysis, Prenatal testing, Genetic Consultation, Influence Diagrams, Shared Decision making
Last Updated: 17/08/2009 23:17:32
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