Article type
Abstract
Background:
Uncertainties pervade every aspect of healthcare, impacting decision-making process. This influence becomes particularly pronounced when evidence-based decisions are required, introducing an additional layer of complexity due to the often low or very low certainty of evidence. Understanding how stakeholders navigate, respond, and trade-off uncertainties is crucial. Analysing the interplay and interconnectedness of the different layers of uncertainties offers insights into their collective influence on decision-making.
Objective:
This paper showcases constructing a conceptual model covering diverse healthcare decision-making levels from insights via a systematic review. The model underpins a participatory research initiative with patients and dentists, exploring their perceptions and responses to uncertainties, particularly navigating low to very low uncertainties in clinical decisions.
Methodology:
Themes from the thematic synthesis guided the development of a concentrically represented overarching uncertainty model (Figure 1). It depicts interdependency across different healthcare uncertainty types at varying levels—macro, meso, and micro. Subsequently, a participatory research approach involved patients and dentists. We examined their perceptions of uncertainties in dental settings and how these influence decision-making. We also explored impacts, especially when decision-making evidence has low to very low certainty.
Results:
The systematic review dissected layers of uncertainty in health decisions, recognizing that uncertainty can evolve during interactions. Dentist-patient involvement showed decision complexity isn't always linked to the number of people influenced; a one-person clinical decision can have multiple uncertainties. Even very personal decisions revealed diverse complexities with various uncertainties. Additionally, our study outlined strategic choices by patients and dentists in navigating uncertainties, yielding intriguing insights, especially in responding to decision-making scenarios with low to very low evidence levels.
Conclusion:
Understanding how end users perceive evidence-based uncertainties and choose trade-offs in clinical decision-making provides insights into managing clinical interactions and prioritizing uncertainties. This knowledge contributes to optimizing decision processes, ultimately leading to enhanced patient care.
Relevance to patients:
Managing uncertainties in oral health decisions is vital to align patient and dentist perspectives, ensuring satisfactory experiences and outcomes for patient welfare. This project facilitated the deconstruction of uncertainties, providing a foundation for developing management strategies to effectively mitigate or trade off uncertainties when elimination is not feasible.
Uncertainties pervade every aspect of healthcare, impacting decision-making process. This influence becomes particularly pronounced when evidence-based decisions are required, introducing an additional layer of complexity due to the often low or very low certainty of evidence. Understanding how stakeholders navigate, respond, and trade-off uncertainties is crucial. Analysing the interplay and interconnectedness of the different layers of uncertainties offers insights into their collective influence on decision-making.
Objective:
This paper showcases constructing a conceptual model covering diverse healthcare decision-making levels from insights via a systematic review. The model underpins a participatory research initiative with patients and dentists, exploring their perceptions and responses to uncertainties, particularly navigating low to very low uncertainties in clinical decisions.
Methodology:
Themes from the thematic synthesis guided the development of a concentrically represented overarching uncertainty model (Figure 1). It depicts interdependency across different healthcare uncertainty types at varying levels—macro, meso, and micro. Subsequently, a participatory research approach involved patients and dentists. We examined their perceptions of uncertainties in dental settings and how these influence decision-making. We also explored impacts, especially when decision-making evidence has low to very low certainty.
Results:
The systematic review dissected layers of uncertainty in health decisions, recognizing that uncertainty can evolve during interactions. Dentist-patient involvement showed decision complexity isn't always linked to the number of people influenced; a one-person clinical decision can have multiple uncertainties. Even very personal decisions revealed diverse complexities with various uncertainties. Additionally, our study outlined strategic choices by patients and dentists in navigating uncertainties, yielding intriguing insights, especially in responding to decision-making scenarios with low to very low evidence levels.
Conclusion:
Understanding how end users perceive evidence-based uncertainties and choose trade-offs in clinical decision-making provides insights into managing clinical interactions and prioritizing uncertainties. This knowledge contributes to optimizing decision processes, ultimately leading to enhanced patient care.
Relevance to patients:
Managing uncertainties in oral health decisions is vital to align patient and dentist perspectives, ensuring satisfactory experiences and outcomes for patient welfare. This project facilitated the deconstruction of uncertainties, providing a foundation for developing management strategies to effectively mitigate or trade off uncertainties when elimination is not feasible.