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Patient-centred care • shared decision-making • surgical adverse events • complications • discrete choice experiments • pediatric surgery • patient-reported outcomes • decisional aids • surgical wait time
The surgical decision-making process often involves a weighing of risks and benefits of alternative surgical procedures, or surgical vs. medical therapies. Even when shared decision-making is used, the choices considered are based on surgeon-centred experience and complication scores, as the actual patient burden following specific postoperative complications is not yet quantified. I plan to leverage cognitive neuroscience findings to create and then validate a tool that will allow patients to provide individualized metrics of the risks and benefits of surgery. This tool can then be used to empower patients to help them make ultimately satisfactory surgical decisions.
To achieve this I am using discrete choice experiment (DCE) to capture patient preferences and derive patient-centred complication weights, as well as explore and identify contextual, temporal, and demographic factors influencing their choices.
Poenaru D, Pemberton J, Frankfurter C, Cameron BH, Stolk E. Establishing disability weights for congenital paediatric surgical conditions: a prospective, cross-sectional, multi-modal approach. Pop Health Metrics 15:1-11, 2017.
Saxton AT, Poenaru D, Ozgediz D, Ameh Emmanuel A, Farmer D, Rice HE. Economic analysis of children’s surgical care in low- and middle-income countries: A systematic review. PLOS ONE 11:e01654480, 2016.
Yousef Y, Lee A, Ayele F, Poenaru D. Delayed access to care and unmet burden of pediatric surgical disease in resource-constrained African countries. Journal of Pediatric Surgery. 2018 Jun 27.
Poenaru D, Pemberton J, Cameron BH. The Burden of Waiting: DALYs accrued from delayed access to pediatric surgery in Kenya and Canada. J Pediatr Surg 50:765-70, 2015.
Poenaru D, Pemberton J, Frankfurter C, Cameron BH. Quantifying the Disability Averted through Pediatric Surgery: a cross-sectional comparison of a pediatric surgical unit in Kenya and Canada. World J Surg 39:2198-2206, 2015.