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      Shared decision-making in neurosurgery: a scoping review

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          Abstract

          Background

          In modern neurosurgery, there are often several treatment alternatives, with different risks and benefits. Shared decision-making (SDM) has gained interest during the last decade, although SDM in the neurosurgical field is not widely studied. Therefore, the aim of this scoping review was to present the current landscape of SDM in neurosurgery.

          Methods

          A literature review was carried out in PubMed and Scopus. We used a search strategy based on keywords used in existing literature on SDM in neurosurgery. Full-text, peer-reviewed articles published from 2000 up to the search date February 16, 2021, with patients 18 years and older were included if articles evaluated SDM in neurosurgery from the patient’s perspective.

          Results

          We identified 22 articles whereof 7 covered vestibular schwannomas, 7 covered spinal surgery, and 4 covered gliomas. The other topics were brain metastases, benign brain lesions, Parkinson’s disease and evaluation of neurosurgical care. Different methods were used, with majority using forms, questionnaires, or interviews. Effects of SDM interventions were studied in 6 articles; the remaining articles explored factors influencing patients’ decisions or discussed SDM aids.

          Conclusion

          SDM is a tool to involve patients in the decision-making process and considers patients’ preferences and what the patients find important. This scoping review illustrates the relative lack of SDM in the neurosurgical literature. Even though results indicate potential benefit of SDM, the extent of influence on treatment, outcome, and patient’s satisfaction is still unknown. Finally, the use of decision aids may be a meaningful contribution to the SDM process.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00701-021-04867-3.

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          Most cited references57

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012–2016

            The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.41 (Malignant AAAIR = 7.08, non-Malignant AAAIR = 16.33). This rate was higher in females compared to males (25.84 versus 20.82), Whites compared to Blacks (23.50 versus 23.34), and non-Hispanics compared to Hispanics (23.84 versus 21.28). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.6% of all tumors), and the most common non-malignant tumor was meningioma (37.6% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0–19 years), the incidence rate of all primary brain and other CNS tumors was 6.06. An estimated 86,010 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2019 (25,510 malignant and 60,490 non-malignant). There were 79,718 deaths attributed to malignant brain and other CNS tumors between 2012 and 2016. This represents an average annual mortality rate of 4.42. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.8%, and the five-year relative survival rate following diagnosis of a non-malignant brain and other CNS tumors was 91.5%.
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              Shared decision making--pinnacle of patient-centered care.

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                Author and article information

                Contributors
                alba.corell@vgregion.se
                annie.guo@neuro.gu.se
                tomas.gomez.vecchio@gu.se
                anneli.ozanne@gu.se
                jakola.asgeir@gu.se
                Journal
                Acta Neurochir (Wien)
                Acta Neurochir (Wien)
                Acta Neurochirurgica
                Springer Vienna (Vienna )
                0001-6268
                0942-0940
                3 May 2021
                3 May 2021
                2021
                : 163
                : 9
                : 2371-2382
                Affiliations
                [1 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Neurosurgery, , Sahlgrenska University Hospital, ; Blå stråket 5, 41345 Gothenburg, Sweden
                [2 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, , University of Gothenburg, Sahlgrenska Academy, ; Gothenburg, Sweden
                [3 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Institute of Health and Care Sciences, , Sahlgrenska Academy, University of Gothenburg, ; Gothenburg, Sweden
                [4 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Neurology, , Sahlgrenska University Hospital, ; Gothenburg, Sweden
                [5 ]GRID grid.52522.32, ISNI 0000 0004 0627 3560, Department of Neurosurgery, , St.Olavs University Hospital, ; Trondheim, Norway
                Author information
                http://orcid.org/0000-0002-6329-2392
                Article
                4867
                10.1007/s00701-021-04867-3
                8357744
                33942189
                2429f316-b812-4c84-8f5a-d485a2e96198
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 March 2021
                : 26 April 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004359, Vetenskapsrådet;
                Funded by: FundRef http://dx.doi.org/10.13039/501100005689, Göteborgs Läkaresällskap;
                Funded by: University of Gothenburg
                Categories
                Review Article - Neurosurgery general
                Custom metadata
                © Springer-Verlag GmbH Austria, part of Springer Nature 2021

                Surgery
                decision-making,shared,neurosurgery,surgical oncology,spine,patient-centered care,decision aids
                Surgery
                decision-making, shared, neurosurgery, surgical oncology, spine, patient-centered care, decision aids

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