{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:43:02Z","timestamp":1788403382663,"version":"build-2803163510"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"\n Importance<\/jats:title>\n Alopecia areata (AA) is an autoimmune disorder of hair loss with a complex and evolving treatment landscape, making it an ideal setting for shared decision-making (SDM) between patients and physicians. Given the varying efficacy, experience, and risks of treatments for AA, we sought to evaluate patient preferences for SDM and the association of SDM with decisional regret.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate patient preferences for SDM and the association of SDM with decisional regret.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A cross-sectional online survey using the validated SDMQ9 scale for shared decision-making and Decisional Regret Scale (DRS) was distributed using the National Alopecia Areata Foundation (NAAF) with the aim of assessing (1) patient preferences in SDM when making treatment decisions, (2) how patients perceived the last decision to have been made, (3) which components of SDM were incorporated into the last decision, and (4) decisional regret related to their last treatment decision. The survey was distributed from July 12, 2021, to August 2, 2021, and data analysis occurred from October 2021 to March 2022.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes included (1) patient preferences in incorporation of SDM, (2) how patients made their most recent treatment decision, (3) which components of SDM were incorporated into their most recent treatment decision measured with the validated SDMQ9, and (4) an assessment of decisional regret in relation to SDM components and the most recent treatment modality used by the patient as measured by the validated DRS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1387 individuals who initiated the survey, 1074 completed it and were included in the analysis (77.4% completion rate). Overall, 917 respondents were women (85.4%). There were 5 American Indian or Alaska Native respondents (0.5%), 33 were Asian (3.1%), 112 Black or African American (10.4%), 836 White (77.8%), and 36 were multiracial (3.4%) or other (36 [3.4%]). The mean age (SD) was 49.3 (15.4) years. Most respondents preferred making the final treatment decision themselves after considering their physician\u2019s opinion (503 [46.8%]). Of those who preferred to make treatment decisions using SDM, most made the last AA treatment decision with their physician (596 [55%]; 95% CI, 53%-58%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). The components of SDM implemented by the patients\u2019 dermatologists most identified were the physician \u201cexplained the advantages and disadvantages of treatment options\u201d (472 [44%]), and the physician \u201casked me which treatment option I prefer\u201d (494 [45.9%]). Incorporation of SDM by physicians was generally associated with decreased decisional regret (all ORs with 95% CIs greater than 1.1;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.01). The treatments associated with the lowest decisional regret were Janus kinase (JAK) inhibitors, followed by biologics, and deciding not to treat; whereas, the highest decisional regret was reported with anthralin and minoxidil.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this cross-sectional survey study suggest that patients with AA prefer to make treatment decisions with their dermatologist using SDM. When SDM is used, patients report less decisional regret, indicating that SDM may help improve the patient-reported quality of treatment decisions. Newer, more efficacious therapies such as JAK inhibitors may be related to lower decisional regret. Future studies should seek to devise solutions to implement SDM as the AA treatment landscape continues to evolve.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2022.3025","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T12:01:45Z","timestamp":1660910505000},"page":"1187","source":"Crossref","is-referenced-by-count":26,"title":["Shared Decision-Making, Therapeutic Choice, and Decisional Regret in Patients With Alopecia Areata"],"prefix":"10.1001","volume":"158","author":[{"given":"Sophia","family":"Reyes-Hadsall","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane J.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen J.","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Mostaghimi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathie P.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"1","key":"dbr220015r1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.jaad.2017.04.1142","article-title":"Alopecia areata: An appraisal of new treatment approaches and overview of current therapies.","volume":"78","author":"Strazzulla","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"dbr220015r2","doi-asserted-by":"publisher","first-page":"S116","DOI":"10.1016\/j.jid.2021.02.698","article-title":"668 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mental health resources and complementary and alternative therapies for alopecia areata: a U.S. survey.","volume":"9","author":"Hussain","year":"2017","journal-title":"Int J Trichology"},{"issue":"1","key":"dbr220015r15","doi-asserted-by":"publisher","first-page":"S62","DOI":"10.1016\/j.jisp.2020.05.007","article-title":"Burden of illness in alopecia areata: a cross-sectional online survey study.","volume":"20","author":"Mesinkovska","year":"2020","journal-title":"J Investig Dermatol Symp Proc"},{"key":"dbr220015r11","unstructured":"H\u00e4rter? M. Patient Als Partner. http:\/\/www.patient-als-partner.de\/index.php?article_id=20&clang=2\/. Accessed2021."}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2795016\/jamadermatology_reyeshadsall_2022_br_220015_1666117459.38675.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T11:10:10Z","timestamp":1666177810000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2795016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,1]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2022.3025","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10,1]]}}}