Clinical Scorecard: Collaborative Decision-Making in Neurosurgical Procedures for Brain Tumors
At a Glance
Category
Detail
Condition
Brain tumors including high-grade glioma (HGG), low-grade glioma (LGG), and metastases
Key Mechanisms
Shared decision-making (SDM) involving patients, families, and clinical teams to consider patient values, preferences, and risks/benefits of treatment options
Target Population
Patients undergoing neurosurgical treatment consideration for brain tumors
Care Setting
High-volume neuro-oncological center within the NHS, outpatient clinic setting
Key Highlights
SDM is a legal requirement in UK healthcare following the 2015 Montgomery v Lanarkshire Health Supreme Court ruling.
Team training including role play and patient involvement improves SDM implementation and patient satisfaction.
Decision aids (decision grids) based on NICE guidelines were developed to facilitate SDM in brain tumor treatment.
Guideline-Based Recommendations
Diagnosis
Use NICE guidelines to inform treatment options and decision aids for brain tumor patients.
Management
Implement SDM as the standard of care, ensuring patients understand material risks and alternatives.
Train clinical teams using interactive methods such as role play to integrate SDM into routine practice.
Monitoring & Follow-up
Assess patient satisfaction with SDM using validated tools like the CollaboRATE score.
Evaluate healthcare staff attitudes toward SDM using instruments such as the AquA questionnaire.
Risks
Failure to engage patients in SDM may lead to suboptimal consent and reduced patient satisfaction.
Lack of organizational support and training can hinder effective SDM implementation.
Patient & Prescribing Data
Patients with brain tumors (HGG, LGG, metastases) attending first clinic visits for treatment consideration
Post-SDM training, increased patient satisfaction was observed; decision aids support informed choices aligned with patient values.
Clinical Best Practices
Engage all clinical team members, not only doctors, in SDM processes to ensure consistent patient support.
Use patient activation campaigns (e.g., 'ask 3 questions') to encourage patient involvement.
Combine organizational support, clinician training, and patient education for successful SDM implementation.
Develop and utilize concise decision aids based on current guidelines to facilitate patient understanding.
