Evidence map›Paper›PMID 37407039›Full record

ArticleBMJ open2023

Protocol paper for SMART OPS: Shared decision-making Multidisciplinary Approach - a Randomised controlled Trial in the Older adult Population considering Surgery.

Pragya Ajitsaria, Natalie Lott, Angela Baker, Jeanette Lacey, Monique Magnusson, Jeanene Lizbeth Douglas, Paul Healey, Eileen Tan-Gore, Stuart V Szwec, Daniel Barker and 5 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Pragya AjitsariaDepartment of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia pragya.ajitsaria@health.nsw.gov.au.ORCID 0000-0003-0511-7374
Natalie LottSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0001-5905-6357
Angela BakerDepartment of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID 0000-0001-9482-4286
Jeanette LaceySchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0002-7539-0352
Monique MagnussonDepartment of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID 0000-0002-2854-2202
Jeanene Lizbeth DouglasDepartment of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID 0000-0003-4174-5255
Paul HealeyDepartment of Anaesthesia, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID 0000-0002-7224-1191
Eileen Tan-GoreDepartment of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia.ORCID 0000-0002-5653-2853
Stuart V SzwecHunter Medical Research Institute, Newcastle, New South Wales, Australia.ORCID 0000-0001-8549-1934
Daniel BarkerHunter Medical Research Institute, Newcastle, New South Wales, Australia.ORCID 0000-0002-9707-4465
Simon DeemingHealth Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia.ORCID 0000-0002-5418-3936
Meredith TavenerSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0002-5972-3815
Steve SmithSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0002-1104-133X
Jon GaniSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0003-0655-1877
John AttiaSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0001-9800-1308

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Australian population presenting with surgical pathology is becoming older, frailer and more comorbid. Shared decision-making is rapidly becoming the gold standard of care for patients considering high-risk surgery to ensure that appropriate, value-based healthcare decisions are made. Positive benefits around patient perception of decision-making in the immediacy of the decision are described in the literature. However, short-term and long-term holistic patient-centred outcomes and cost implications for the health service require further examination to better understand the full impact of shared decision-making in this population.

methodsWe propose a novel multidisciplinary shared decision-making model of care in the perioperative period for patients considering high-risk surgery in the fields of general, vascular and head and neck surgery. We assess it in a two arm prospective randomised controlled trial. Patients are randomised to either 'standard' perioperative care, or to a multidisciplinary (surgeon, anaesthetist and end-of-life care nurse practitioner or social worker) shared decision-making consultation. The primary outcome is decisional conflict prior to any surgical procedure occurring. Secondary outcomes include the patient's treatment choice, how decisional conflict changes longitudinally over the subsequent year, patient-centred outcomes including life impact and quality of life metrics, as well as morbidity and mortality. Additionally, we will report on healthcare resource use including subsequent admissions or representations to a healthcare facility up to 1 year. ETHICS AND DISSEMINATION: This study has been approved by the Hunter New England Human Research Ethics Committee (2019/ETH13349). Study findings will be presented at local and national conferences and within scientific research journals. TRIAL REGISTRATION NUMBER: ACTRN12619001543178.

Indexed as

Quality of LifeSurgeonsAgedAustraliaDecision Making, SharedHumansProspective StudiesRandomized Controlled Trials as TopicAdult anaesthesiaAdult surgeryANAESTHETICSGERIATRIC MEDICINEHEALTH ECONOMICS

Identifiers

PMID37407039
PMCPMC10335422

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.