Evidence map›Paper›PMID 40578873›Full record

ArticleBMJ open2025

Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study.

Christin Hoffmann, Kerry N L Avery, Rhiannon C Macefield, Val Snelgrove, Leila Rooshenas, Hilary L Bekker, Della Hopkins, Christie Cabral, Jane M Blazeby, Ben Gibbison and 15 more

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In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

25 authors.

Christin HoffmannNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK c.hoffmann@bristol.ac.uk.ORCID http://orcid.org/0000-0002-6293-3813
Kerry N L AveryNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0001-5477-2418
Rhiannon C MacefieldNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-6606-5427
Val SnelgrovePatient Representative, Bristol, UK.
Leila RooshenasNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-6166-6055
Hilary L BekkerLeeds Unit of Complex Intervention Development (LUCID), Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK.
Della HopkinsNorth Bristol NHS Trust, Bristol, UK.
Christie CabralCentre for Academic Primary Care, Bristol University, Bristol Medical School, Bristol, UK.
Jane M BlazebyNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-3354-3330
Ben GibbisonNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0003-3635-6212
Shireen HickeyBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Adam WilliamsNorth Bristol NHS Trust, Bristol, UK.
Jon AningBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Andrew JudgeNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0003-3015-0432
Andrew SmithNorth Bristol NHS Trust, Bristol, UK.
Archana LingampalliNorth Bristol NHS Trust, Bristol, UK.
Barnaby ReevesBristol Trials Centre, Population Health Sciences, University of Bristol, Bristol Medical School, Bristol, UK.ORCID http://orcid.org/0000-0002-5101-9487
Jessica PreshawNorth Bristol NHS Trust, Bristol, UK.
Michael R WhitehouseNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0003-2436-9024
Paul CresswellNorth Bristol NHS Trust, Bristol, UK.
Philip BraudeNorth Bristol NHS Trust, Bristol, UK.
Shelley PotterNorth Bristol NHS Trust, Bristol, UK.ORCID http://orcid.org/0000-0002-6977-312X
Timothy BeckittNorth Bristol NHS Trust, Bristol, UK.
Timothy WhittlestoneNorth Bristol NHS Trust, Bristol, UK.
Angus G K McNairNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0002-2601-9258

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore patient and healthcare professional perceptions about the acceptability and impact of a large-scale system for automated, real-time monitoring and feedback of shared decision-making (SDM) that has been integrated into surgical care pathways.

designQualitative, semistructured interviews were conducted with patients and healthcare professionals between June and November 2021. Data were analysed using deductive and inductive approaches.

settingLarge-scale monitoring of SDM has been integrated in NHS surgical care across two large UK National Health Service Trusts.

participantsAdult surgical patients (N=18, 56% female), following use of an SDM real-time monitoring and feedback system, and healthcare professionals (N=14, 36% female) involved in their surgical care. Patient recruitment was conducted through hospital research nurses and professionals by direct approach from the study team to sample individuals purposively from seven surgical specialties (general, vascular, urology, orthopaedics, breast, gynaecology and urgent cardiac).

results10 themes were identified within three areas of exploration that described factors underpinning: (1) the acceptability of large-scale automated, real-time monitoring of SDM experiences, (2) the acceptability of real-time feedback and addressing SDM deficiencies and (3) the impact of real-time monitoring and feedback. There was general support for real-time monitoring and feedback because of its perceived ability to efficiently address deficiencies in surgical patients' SDM experience at scale, and its perceived benefits to patients, surgeons and the wider organisation. Factors potentially influencing acceptability of large-scale automated, real-time monitoring and feedback were identified for both stakeholder groups, for example, influence of survey timing on patient-reported SDM scores, disease-specific risks, patients' dissatisfaction with hospital processes. Factors particularly important for patients included concerns over digital exclusion exacerbated by electronic real-time monitoring. Factors unique to professionals included the need for detailed, qualitative feedback of SDM to contextualise patient-reported SDM scores.

conclusionsThis study explored factors influencing the acceptability of automated, real-time monitoring and feedback of patients' experiences of SDM integrated into surgical practice, at scale among key stakeholders. Findings will be used to guide refinement and implementation of SDM monitoring and feedback prior to formal development, evaluation and implementation of an SDM intervention in the NHS. TRIAL REGISTRATION NUMBER: ISRCTN17951423. THE ORIGINAL PROTOCOL: doi: 10.1136/bmjopen-2023-079155.

Indexed as

Attitude of Health PersonnelDecision Making, SharedPatient ParticipationSurgeonsAdultAgedFeedbackFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchState MedicineUnited KingdomDecision MakingHealth policyHealth ServicesQUALITATIVE RESEARCHSURGERY

Identifiers

PMID40578873
PMCPMC12207162

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.