ArticleThe Journal of pediatrics2014
Real life clinic visits do not match the ideals of shared decision making.
Article in The Journal of pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Interventions for promoting participation in shared decision-making for children and adolescents with cystic fibrosis.The Cochrane database of systematic reviews · 2019Pooled it
- Barriers and facilitators of pediatric shared decision-making: a systematic review.Implementation science : IS · 2019Pooled it
- Pilot trial of iBDecide: Evaluating an online tool to facilitate shared decision making for adolescents and young adults with ulcerative colitis.Health expectations : an international journal of public participation in health care and health policy · 2022Trial
- Shared decision making in pain care: a systematic review study protocol of decision aids.BMJ open · 2026Article
- Health Care Provider Perspectives on Shared Decision Making With Parents and Adolescents.Clinical pediatrics · 2025Article
- A qualitative study exploring experiences of treatment in paediatric rheumatology - children's, young people's, parents' and carers' perspectives.Pediatric rheumatology online journal · 2025Article
- Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development: Common Ground and Opportunities for Improvement.Hormone research in paediatrics · 2025Article
- "I'd like more options!": Interviews to explore young people and family decision-making needs for pain management in juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2023Article
- Audiovisual Recording in the Inpatient Setting: A Method for Studying Parent-Nurse Communication.Journal of family nursing · 2023Article
- Editorial: Shared Decision Making in Pediatric Differences/Disorders of Sex Development.Frontiers in urology · 2023Article
- Surgical Decision-Making for Individuals with Differences of Sex Development: Stakeholders' views.Frontiers in urology · 2023Article
- Evaluating provider communication in pediatric chronic kidney disease care using a global coding system.Patient education and counseling · 2020Article
- Shared decision making in IBD: A novel approach to trial consent and timing.Contemporary clinical trials communications · 2019Article
- Development of a decision support tool in pediatric Differences/Disorders of Sex Development.Seminars in pediatric surgery · 2019Article
- A shared decision-making tool for individuals living with complete androgen insensitivity syndrome.Seminars in pediatric surgery · 2019Article
- A Learning Loop Model of Collaborative Decision-Making in Chronic Illness.Academic pediatrics · 2019Article
- Shared Decision Making About Starting Anti-TNFs: A Pediatric Perspective.Journal of pediatric gastroenterology and nutrition · 2019Article
- Involving Youth With a Chronic Illness in Decision-making: Highlighting the Role of Providers.Pediatrics · 2018Article
- An expanded framework to define and measure shared decision-making in dialogue: A 'top-down' and 'bottom-up' approach.Patient education and counseling · 2018Article
- Patient-provider communication in nephrology care for adolescents and young adults.Patient education and counseling · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo use observation to understand how decisions about higher-risk treatments, such as biologics, are made in pediatric chronic conditions.
methodsGastroenterology and rheumatology providers who prescribe biologics were recruited. Families were recruited when they had an outpatient appointment in which treatment with biologics was likely to be discussed. Consent/assent was obtained to video the visit. Audio of the visits in which a discussion of biologics took place were transcribed and analyzed. Our coding structure was based on prior research, shared decision making (SDM) concepts, and the initial recorded visits. Coded data were analyzed using content analysis and comparison with an existing model of SDM.
resultsWe recorded 21 visits that included discussions of biologics. In most visits, providers initiated the decision-making discussion. Detailed information was typically given about the provider's preferred option with less information about other options. There was minimal elicitation of preferences, treatment goals, or prior knowledge. Few parents or patients spontaneously stated their preferences or concerns. An implicit or explicit treatment recommendation was given in nearly all visits, although rarely requested. In approximately one-third of the visits, the treatment decision was never made explicit, yet steps were taken to implement the provider's preferred treatment.
conclusionsWe observed limited use of SDM, despite previous research indicating that parents wish to collaborate in decision making. To better achieve SDM in chronic conditions, providers and families need to strive for bidirectional sharing of information and an explicit family role in decision making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.