{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T06:50:03Z","timestamp":1777099803367,"version":"3.51.4"},"reference-count":49,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Knowledge Institute of the Dutch Association of Medical Specialists"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,26]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients\u2019 preferences, values and contexts are important elements of the shared decision-making (SDM) process. We captured those elements into the concept of \u2018personal perspective elicitation\u2019 (PPE), which reflects the need to elicit patients\u2019 preferences, values and contexts in patient\u2013clinician conversations. We defined PPE as: \u2018the disclosure (either elicited by the clinician or spontaneously expressed by the patient) of information related to the patient\u2019s personal preferences, values and\/or contexts potentially relevant to decision-making\u2019. Our goal was to operationalise the concept of PPE through the evaluation of preferences, values and contexts and explore how PPE occurs in clinical encounters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study: observational coding based on a novel coding scheme of audio-recorded outpatient clinical encounters where encounter patient decision aids were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      We audio-recorded patient\u2013clinician interactions at three Dutch outpatient clinics. PPE was analysed using a novel observational coding scheme, distinguishing preferences, contexts and four Armstrong taxonomy value types (global, decisional, external and situational). We measured SDM using the Observer OPTION\n                      <jats:sup>5<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Twenty patients who suffered from psoriasis or ovarian cysts; four clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 20 audio-recordings. The mean Observer OPTION\n                      <jats:sup>5<\/jats:sup>\n                      score was 57.5 (SD:10.1). The audio-recordings gave a rich illustration of preferences, values and contexts that were discussed in the patient\u2013clinician interactions. Examples of identified global values: appearance, beliefs, personality traits. Decisional values were related to the process of decision-making. External values related to asking advice from for example, the clinician or significant others. An identified situational value: a new job ahead. Contexts related to how the illness impacted the life (eg, sexuality, family, sports, work life) of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The operationalisation of PPE, an important aspect of SDM, explores which preferences, values and contexts were discussed during patient\u2013clinician interactions where an ePDA was used. The coding scheme appeared feasible to apply but needs further refinement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079540","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T02:26:08Z","timestamp":1715912768000},"page":"e079540","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Explorative observational study of Dutch patient\u2013clinician interactions: operationalisation of personal perspective elicitation as part of shared decision-making in real-life audio-recorded consultations"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2262-3818","authenticated-orcid":false,"given":"Ester A","family":"Rake","sequence":"first","affiliation":[{"name":"IQ Health, Radboudumc, Nijmegen, The Netherlands"},{"name":"Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjan J","family":"Meinders","sequence":"additional","affiliation":[{"name":"Radboudumc IQ Healthcare, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guus","family":"Brand","sequence":"additional","affiliation":[{"name":"Radboudumc IQ Healthcare, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5039-3370","authenticated-orcid":false,"given":"Dunja","family":"Dreesens","sequence":"additional","affiliation":[{"name":"Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan A M","family":"Kremer","sequence":"additional","affiliation":[{"name":"Radboudumc IQ Healthcare, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0917-6286","authenticated-orcid":false,"given":"Glyn","family":"Elwyn","sequence":"additional","affiliation":[{"name":"Radboudumc IQ Healthcare, Nijmegen, The Netherlands"},{"name":"Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna W M","family":"Aarts","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Amsterdam UMC University Medical Center, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"2025120618335472000_14.5.e079540.1","unstructured":"Institute of Medicine (US) Committee on Quality of Health Care in America . 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