Patient-centred decision making: using evidence from bedside to health policies

Article type
Authors
Stacey D, Shrier I, Gauvin F, Boivin A, Légaré F
Abstract
Although systematic reviews aim to improve patient outcomes, to achieve this aim evidence needs to be used to inform decisions by patients, the public, healthcare professionals, managers, and policy makers. Moreover, challenges interfere with this goal. First, current approaches to evidence production and dissemination typically focuses on reporting the evidence but not in formats or language that facilitates patient and public decision making. Second, patients and the public are not aware of systematic reviews as an important strategy for establishing best available evidence about interventions to improve patient outcomes. Increasing patient and public input into how systematic reviews or clinical practice guidelines are designed, conducted, or translated may provide solutions. Therefore, to ensure that reviews achieve their aim of improving patient outcomes, we need to consider: (a) how patients and the public can participate in the production of systematic reviews to ensure better alignment with their priorities; and (b) how we can better support the use of synthesized evidence to guide healthcare decisions from bedside to health policies. The special session is being planned by an interprofessional team including a patient and all team members will present during the symposium. It will begin with a short conversation between a patient and clinician discussing the evidence for management of low back pain. This clinical vignette will highlight the challenges in getting evidence to guide decisions in clinical practice through to health policies. Three brief presentations will propose solutions to address various challenges associated with engaging patients and the public in evidence production and use. The session will conclude with an open discussion/debate among the panel and the audience. Panellists will be: (1) Dawn Stacey RN, PhD who holds a University Research Chair in Knowledge Translation to Patients, is an Associate Professor at the University of Ottawa, and Scientist at the Ottawa Hospital Research Institute where she leads the Patient Decision Aids Research Group. She is the principal author on the Cochrane Review of Patient Decision Aids. (2) Ian Shrier MD, PhD is a practicing sport medicine physician, Associate Professor and researcher at the Centre for Clinical Epidemiology at the Jewish General Hospital, McGill University in Montreal. His research is focused on general epidemiological methods, and how people interpret systematic reviews. (3) Franc¸ois-Pierre Gauvin, PhD, is the Knowledge Broker for the Cochrane Policy Liaison Office and Lead Evidence Synthesis and Francophone Outreach of the McMaster Health Forum. His area of expertise includes deliberative dialogues, such as citizen panels and stakeholder dialogues, which are promising mechanisms to find innovative solutions to collective problems. (4) Antoine Boivin MD, PhD is a practicing family physician, associate professor, and researcher at Universite´ de Sherbrooke. His research focuses on patient and public involvement in healthcare improvement. He led the first trial of patient and public involvement in healthcare priority-setting. (5) Jean Le´ gare´ is a retired business man, healthcare consumer, and patient advocate. He served as the co-chair of the Consumer Advisory Council for the Canadian Arthritis Network Centre of Excellence, Master Trainerwith the Arthritis Self-Management Program, participant in the Patient Partners in Arthritis program, steering committee member of the Best Medicines Coalition, and is a patient representative on research studies. He founded the Canadian Arthritis Patient Alliance. In 2008, he received an honorary doctorate at Laval University for patient advocacy and partnerships in research.

Target audience and level of expertise: This session will be open to all Cochrane Colloquium attendees. There is no required level of expertise to participate.