Elicitation of personal perspective during patient-clinician conversations using a decision aid: Presenter(s): Ester Rake, Radboud university medical center; Knowledge Institute of the Dutch Federation of Medical Specialists, Netherlands

Shared decision-making (SDM) is reliant on eliciting the patient’s personal perspective. It is assumed that the use of encounter patient decision aids (ePDAs) facilitate this. We named this element personal perspective elicitation (PPE). We define this as the disclosure (either elicited by the clinician or spontaneously expressed by the patient) of information related to the patient’s personal preferences, values, and/or context, that is potentially relevant to the process of decision-making. It is unclear whether PPE happens in daily clinical practice. We aim to evaluate to what extent PPE occurred in conversations between patients and clinicians in which an ePDA was used. We audio-recorded 20 encounters from May 2021 until January 2022 in outpatient clinics of three Dutch hospitals. The analysis primarily focused on coding the extent of PPE using a codebook based on two coding schemes for observational data: the VR-CoDES (developed for coding emotional talk) and the Voice of Lifeworld and medicine dynamic (developed to distinguish between biomedical and contextual aspects). To study PPE in the context of SDM, we used the Observer OPTION-5 and a fidelity-of-use checklist. Reliability scores were calculated. Finally, we tested whether item 4 of the Observer OPTION 5 (‘’has the clinician explored patient preferences and linked them to the options’’) was correlated with the extent of PPE. We included 13 audio-recordings from the gynaecology clinics, and 7 from the dermatology clinic. Analysis of the audio-recordings by two researchers independently will be done from February 2022 – June 2022. We anticipate finding low levels of PPE, based on the results of a recently conducted scoping review (under review). This is because attention to biomedical issues remains the main focus in current clinical practice, and interest in personal and contextual perspectives is rare.