Shared decision support system on dental restoration

摘要

Shared decision making (SDM) is an approach in which doctor–patient communication regarding available evidence and patient preferences is facilitated to enable the patient to participate in treatment decisions. SDM affords not only the inclusion of the ethical diversities involved in patient-centered care, but also the quality improvements in decision-making process. Though SDM has been studied extensively, there have been few practical implementations in real clinical environments. In this paper, we propose a shared decision-making system with its focus on dental restorative treatment planning. In our system, restorative treatment alternatives for SDM were generated by employing an ontology that had captured the clinical knowledge required for treatments. We considered patient preferences for treatment as an important support for mutual agreements between the patient and the doctor on healthcare decisions. We constructed a consistent and robust hierarchy of preferences using the analytic hierarchy process (AHP) method, to help determine treatment priorities. On the basis of our proposed system, we developed a Web-based application for the visualization of evidence-based treatment recommendations with preference-based weights. We tested our system using a scenario to illustrate how doctors and patients can make shared decisions. The application is of high value in supporting SDM between doctors and patients, and expedites effective treatments and enhanced patient satisfaction.