Exploring the state of shared decision-making in head and neck oncology: Assessing treatment communication

Objective: To explore the state of shared decision-making (SDM) in head and neck (HN) oncology by investigating the extent to which SDM is currently employed by HN surgeons and how the perceived levels of SDM relate to the observed levels of SDM. Additionally, surgeon and patient perspectives on patient involvement in SDM and potential associations with observed levels of SDM were explored. Methods: Perceived level of SDM and patient involvement were measured by SDM-Q-9/SDM-Q-Doc resp. Control Preference Scale. Observed SDM was measured by analyzing audiotaped consultations (N = 42) using the OPTIONmcc+ instrument. Univariate linear analyses were conducted to identify possible associations with surgeon-observed SDM. Results: Median perceived SDM scores of surgeons (74.4 %) and patients (71.1 %) were relatively high, whereas observed median OPTION-scores were moderate (surgeons 48 %, patients 42 %, caregivers 24 %). Consultation time and patient OPTION-score were positively associated with surgeon OPTION-score. Conclusion: Surgeons and patients seem to overestimate the extent of SDM compared to the observed reality. Patients’ goals, values and preferences need to be addressed more during consultations. Practice Implications: The findings can be used to raise awareness of SDM among surgeons to improve their skills. Routine training in medical education can benefit from effective integration of SDM principles during consultations.