WHAT'S IMPORTANT TO PATIENTS? USING TOOLS FROM MARKETING AND EDUCATION TO ASSESS DISPARATE PERSPECTIVES AND IMPROVE DECISION SUPPORT TOOLS

Overview: This course will address why it is important to understand what patients and healthcare providers value, and the need to improve how preferences are assessed and incorporated into decision making. We will present a basic overview of the strengths and limitations of commonly-used approaches for understanding what is important to patients and providers, including focus groups, values clarification approaches, utility assessment tools, and analytic hierarchical processes. We will spend most of the session introducing two methods for assessing preferences and affect: real-time response (affect trace) and cognitive mapping (nominal group technique and card sorting). We will describe these methods and their applications, including an interactive session with hands-on activities to ensure that participants can apply these tools in their own work. We will present an example of how information is collected using affect trace and how this process was used to inform physician assumptions and treatment options available to their patients and to help them understand patients’ fears, concerns, and biases. We will demonstrate how it was then applied to the development of a multimedia decision aid. We will describe how these findings affected the content, approach, voice and user design, and how the resulting decision aid was received by the second wave of patient focus group patients who reviewed it. Course Objectives: 1) To identify and recognize differences in perspectives on multidisciplinary teams, and learn approaches to arriving at a shared point of view; 2) To describe Nominal Group Technique to elicit and prioritize preferences; 3) To describe Moment-to-Moment Affect Trace to assess and measure preferences and affect; 4) To apply advanced data mining techniques to reveal underlying patterns of response in the moment-to-moment affect rating data that otherwise could not be detected using traditional demographics; 5) To illustrate how findings from preference elicitation techniques can be incorporated to improve decision aids and to improve provider understanding of patient concerns and communication.

Background: When developing patient decision aids, a multidisciplinary team that extends beyond a single medical specialty is often needed to advise on the content, framing, and range of treatment options. While this provides key perspectives, incorporating disparate opinions regarding what is important to patients or providers is one of the most fundamental challenges of decision aid development. Different healthcare providers encounter patients at different points in their journey when patients may have different concerns, priorities, and symptoms. And patients can be a dubious source of what they think they need to know. The tools decision analysts use to assess patient preferences and values differ from those used by marketers and educators. While the need for assessing patient preferences is gaining increasing acceptance, there are limitations to the methods commonly used to assess preferences.

Format Requirements: This interactive course will include lecture, demonstrations and interactive class exercises. During the session, participants will participate in interactive exercises that: 1) demonstrate the use of Nominal Group Technique to assess and prioritize values, and affect trace to assess the emotions of class participants; 2) apply knowledge gained by designing a preference assessment tool for a clinical topic; and 3) apply findings from exercises to the design or roll-out of a decision aid. Participants are assumed to be familiar with the general concepts of medical decision making, and to be interested in their application to developing, testing, and integrating decision aids into clinical practice. Beginners are welcome, as are those with more advanced skills in the area. No special computer expertise is required.

Description and Objectives: This course will address why it is important to understand what patients and healthcare providers value and the need to improve how preferences are assessed and incorporated into decision making. We will review of the strengths and limitations of commonly-used approaches for understanding what is important to patients and providers, including focus groups, values clarification approaches, utility assessment tools, and analytic hierarchical processes. We will spend most of the session introducing two methods for assessing preferences and affect: real-time response (affect trace) and cognitive mapping  (nominal group technique and card sorting). We will describe these methods and their applications, including an interactive session with hands-on activities to ensure that participants can apply these tools in their own work.

We will present an example of how information is collected using affect trace, and how this process was used to inform physician assumptions and treatment options available to their patients and to help them understand patients’ fears, concerns, and biases. We will demonstrate how it was applied to developing a multimedia decision aid. We will describe how these findings guided the content, approach, voice and user design, and how the resulting decision aid was received by the second wave of focus group patients who reviewed it.

Course Objectives:

1) Identify and recognize differences in perspectives on multidisciplinary teams, and learn approaches to arrive at a shared perspective.

2) Describe Nominal Group Technique to elicit and prioritize preferences.

3) Describe Moment-to-Moment Affect Trace to assess and measure preferences and affect;

4) Apply advanced data mining techniques to reveal underlying patterns of response in the moment-to-moment affect rating data that otherwise could not be detected using traditional demographics;

5) Illustrate how findings from preference elicitation techniques can be incorporated to improve decision aids and to improve provider understanding of patient concerns and communication.