From Decision to Shared-Decision: Introducing Patients’ Preferences in Clinical Decision Analysis - A Case Study in Thromboembolic Risk Prevention
In the context of the EU project MobiGuide, the development of a patient-centric decision support system based on clinical guidelines is the main focus. The project is addressed to patients with chronic illnesses, including atrial fibrillation (AF). In this paper we describe a shared-decision model framework to address those situations, described in the guideline, where the lack of hard evidence makes it important for the care provider to share the decision with the patient and/or his relatives. To illustrate this subject we focus on an important subject tackled in the AF guideline: thromboembolic risk prevention. We introduce a utility model and a cost model to collect patient’s preferences. On the basis of these preferences and of literature data, a decision model is implemented to compare different therapeutic options. The development of this framework increases the involvement of patients in the process of care focusing on the centrality of individual subjects.
KeywordsDecision Trees Patient Preferences QALYs Atrial Fibrillation
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