Book contents
- Shared Decision Making in Adult Critical Care
- Shared Decision Making in Adult Critical Care
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Chapter 1 When Does Shared Decision-Making Apply in Adult Critical Care?
- Chapter 2 How Much Does the Family Want to Be Involved in Decision-Making?
- Chapter 3 Show Me the Data
- Chapter 4 Communication Skills for Critical Care Family Meetings
- Chapter 5 The Do-Not-Resuscitate Order
- Chapter 6 The Do-Not-Intubate Order
- Chapter 7 Prolonged Ventilator Dependence for the Pulmonary Patient
- Chapter 8 Renal Replacement Therapy
- Chapter 9 Shared Decision-Making during Extracorporeal Membrane Oxygenation
- Chapter 10 Hypoxic–Ischemic Brain Injury after Cardiac Arrest
- Chapter 11 Decompressive Craniectomy for Stroke Patients
- Chapter 12 Decompressive Craniectomy for Traumatic Brain Injury Patients
- Chapter 13 Severe Traumatic Spinal Cord Injury
- Chapter 14 Potentially Inappropriate Treatment and Conscientious Objection
- Chapter 15 Shared Decision-Making in Emergent Situations
- Chapter 16 Advance Directives
- Chapter 17 Care of the Unbefriended Patient
- Chapter 18 The Role of Palliative Care in the Intensive Care Unit
- Chapter 19 Measuring and Evaluating Shared Decision-Making in the Intensive Care Unit
- Chapter 20 Brain Death Discussions
- Index
- References
Chapter 3 - Show Me the Data
Tips for Discussing Numerical Risk in Critical Care
Published online by Cambridge University Press: 27 May 2021
- Shared Decision Making in Adult Critical Care
- Shared Decision Making in Adult Critical Care
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Chapter 1 When Does Shared Decision-Making Apply in Adult Critical Care?
- Chapter 2 How Much Does the Family Want to Be Involved in Decision-Making?
- Chapter 3 Show Me the Data
- Chapter 4 Communication Skills for Critical Care Family Meetings
- Chapter 5 The Do-Not-Resuscitate Order
- Chapter 6 The Do-Not-Intubate Order
- Chapter 7 Prolonged Ventilator Dependence for the Pulmonary Patient
- Chapter 8 Renal Replacement Therapy
- Chapter 9 Shared Decision-Making during Extracorporeal Membrane Oxygenation
- Chapter 10 Hypoxic–Ischemic Brain Injury after Cardiac Arrest
- Chapter 11 Decompressive Craniectomy for Stroke Patients
- Chapter 12 Decompressive Craniectomy for Traumatic Brain Injury Patients
- Chapter 13 Severe Traumatic Spinal Cord Injury
- Chapter 14 Potentially Inappropriate Treatment and Conscientious Objection
- Chapter 15 Shared Decision-Making in Emergent Situations
- Chapter 16 Advance Directives
- Chapter 17 Care of the Unbefriended Patient
- Chapter 18 The Role of Palliative Care in the Intensive Care Unit
- Chapter 19 Measuring and Evaluating Shared Decision-Making in the Intensive Care Unit
- Chapter 20 Brain Death Discussions
- Index
- References
Summary
Shared decision-making involves using the best scientific evidence available to make a choice together with the patient or their surrogate, while weighing the options against the patient’s values, preferences, and goals. A lion’s share of the process, therefore, must be devoted to conveying the clinical information and the science surrounding the available options to the patient, or their surrogate, as is often the case in critical care. There are multiple pitfalls to be aware of when conveying numerical risk to patients and families that can impede their decision-making ability. First, numeracy -- an aspect of literacy that deals specifically with understanding numbers -- can be very poor, even among highly educated people, creating a barrier to comprehending clinical information. Second, the manner in which numerical data are presented can easily manipulate the cognitive biases of patients and their surrogates, limiting their autonomy. Third, clinicians may often present their interpretation of numerical risk rather than the actual data, corrupting the step in shared decision-making where we elicit values and preferences from the patient, imprinting their own values instead. In this Chapter, we explore these issues and discuss ways to optimize the presentation of numerical information.
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- Shared Decision Making in Adult Critical Care , pp. 13 - 18Publisher: Cambridge University PressPrint publication year: 2021