Evidence map›Paper›PMID 39933964›Full record

ArticleBritish journal of anaesthesia2025

Preparing to implement shared decision making in anaesthesia for hip fracture surgery: a qualitative interview study.

Eliana C Goldstein, Mark D Neuman, Viktoria Vonder Haar, Aaron C Li, Carlos E Guerra-Londono, Glyn Elwyn, Stacie G Deiner, Adnan Hussain, Joshua W Sappenfield, Christopher J Edwards and 4 more

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In one paragraph

Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Review
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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

14 authors.

Eliana C GoldsteinDepartment of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Mark D NeumanDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Viktoria Vonder HaarDepartment of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Aaron C LiBrown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA; Harvey A. Friedman Center for Aging, Washington University in St. Louis, St. Louis, MO, USA.
Carlos E Guerra-LondonoDepartment of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health, Detroit, MI, USA.
Glyn ElwynInstitute for Health Policy & Clinical Practice, Dartmouth College Geisel School of Medicine, Lebanon, NH, USA.
Stacie G DeinerDepartment of Anesthesiology, Dartmouth Health and Dartmouth College Geisel School of Medicine, Lebanon, NH, USA.
Adnan HussainDepartment of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health, Detroit, MI, USA.
Joshua W SappenfieldDepartment of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
Christopher J EdwardsDepartment of Anesthesiology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
Sabry AyadDepartment of Anesthesiology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.
James H BaraldiDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Karah WhatleyDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Mary C PolitiDepartment of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA. Electronic address: mpoliti@wustl.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundShared decision making is rarely used in anaesthesia consultations. Because either spinal or general anaesthesia can be appropriate for many patients undergoing surgery to repair a hip fracture, this is an appropriate context to implement and test shared decision making and associated resources for anaesthesia decisions. Conversation aids can facilitate shared decision making between clinicians, patients, and caregivers about treatment choices.

methodsWe conducted semi-structured qualitative interviews at seven sites from April to September 2024 to prepare for implementation of a conversation aid about anaesthesia choices for hip fracture surgery. Interviews elicited feedback on shared decision making and a proposed conversation aid comparing spinal and general anaesthesia.

resultsWe interviewed 12 clinicians and 12 patients and caregivers. The analysis identified four themes, which we mapped to the Practical, Robust Implementation and Sustainability Model. We found (1) broad support for shared decision making in anaesthesia choices before hip fracture surgery, although it is not typically incorporated in current practice; (2) barriers to shared decision making, including institutional culture, preexisting clinician assumptions about patient preferences, and time; (3) features of a resource (i.e. the conversation aid) that can help overcome these barriers; and (4) the importance of engaging in shared decision making with an appropriate clinician. Suggestions from interviews were incorporated into the conversation aid.

conclusionsReasonable shared decision-making strategies such as conversation aids were seen by most participants as helpful to support shared decision making about anaesthesia options for hip fracture surgery. Engaging end users at the local level can address key implementation barriers.

Indexed as

AnesthesiaDecision Making, SharedHip FracturesAgedAged, 80 and overAnesthesia, GeneralAnesthesia, SpinalFemaleHumansInterviews as TopicMaleMiddle AgedPatient ParticipationQualitative Researchgeneral anaesthesiahip fracture surgeryimplementation sciencepatient-centred careshared decision makingspinal anaesthesia

Identifiers

PMID39933964
PMCPMC11947579

What OpenQuestion holds

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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.