Karen Winn1, Elissa Ozanne2, Karen Sepucha3. 1. MGH Institute of Health Professions, Boston, USA. Electronic address: kwinn@mghihp.edu. 2. The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, USA. 3. Harvard Medical School, Boston, USA; Health Decision Sciences Center, Division of General Internal Medicine, Massachusetts General Hospital, Boston, USA.
Abstract
OBJECTIVE: The purpose was to examine recent advances in measuring value concordance and to highlight best practices. METHODS: The paper updates a prior systematic review. A systematic review of the literature from 2008 to 2012 identified articles that reported a relationship between patients' preferences concerning health outcomes and/or medical treatments, and treatment (intended or actual). Relevant articles were independently abstracted by two reviewers. RESULTS: The search identified 3635 unique citations, the full text of 187 articles was examined, and 63 articles covering 61 studies were included, nearly a third more articles than identified in the original review. There were 72 different value concordance calculations, the majority of which were clearly reported with significance. More studies assessed knowledge, reported on the association between value concordance and knowledge, and included a decision aid compared to those in the original review. CONCLUSION: There is increased reporting of value concordance in the literature. However, large differences exist in the way that the measure is defined and calculated. The variability makes it difficult to draw conclusions about the quality of care across studies. PRACTICE IMPLICATIONS: Value concordance is a critical component of patient-centered care, and further attention is needed to establish standards for measurement and reporting.
OBJECTIVE: The purpose was to examine recent advances in measuring value concordance and to highlight best practices. METHODS: The paper updates a prior systematic review. A systematic review of the literature from 2008 to 2012 identified articles that reported a relationship between patients' preferences concerning health outcomes and/or medical treatments, and treatment (intended or actual). Relevant articles were independently abstracted by two reviewers. RESULTS: The search identified 3635 unique citations, the full text of 187 articles was examined, and 63 articles covering 61 studies were included, nearly a third more articles than identified in the original review. There were 72 different value concordance calculations, the majority of which were clearly reported with significance. More studies assessed knowledge, reported on the association between value concordance and knowledge, and included a decision aid compared to those in the original review. CONCLUSION: There is increased reporting of value concordance in the literature. However, large differences exist in the way that the measure is defined and calculated. The variability makes it difficult to draw conclusions about the quality of care across studies. PRACTICE IMPLICATIONS: Value concordance is a critical component of patient-centered care, and further attention is needed to establish standards for measurement and reporting.
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