J Shourick1, M Ahmed2, J Seneschal3, T Passeron4,5, N Andreux3, A Qureshi6, E Y Chow7, P A Natella8, J Harris2, V-T Tran9,10, K Ezzedine1,11. 1. Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), EA7379, Paris-Est University, UPEC, DHU VIC, Créteil, France. 2. Department of Dermatology, University of Massachusetts Medical School, Worcester, MA, 01605, USA. 3. Hôpital Saint-André, CHU Bordeaux, Bordeaux, France. 4. Université Côte d'Azur, Department of Dermatology, CHU Nice, Nice, France. 5. Université Côte d'Azur, INSERM U1065, C3M, Nice, France. 6. Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA. 7. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA. 8. Assistance Publique-Hôpitaux de Paris, Public Health Department/Clinical Research Unit (URC-Mondor), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France. 9. Université de Paris, CRESS, INSERM, INRA, Paris, France. 10. Center d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France. 11. Department of Dermatology, Mondor Hospital (AP-HP), Paris Est Créteil University, Créteil, France.
Abstract
BACKGROUND: Shared decision-making tools (SDMt) are visual tools developed to promote joint medical decisions between physicians and patients. There is a paucity of such tools in dermatology. OBJECTIVES: To develop and validate a SDMt for use in specialized consultation for vitiligo. METHODS: A prospective cross-sectional study was carried out from March 2019 to March 2020. We first conducted a qualitative study of topics discussed by patients and clinicians during therapeutic decision-making in the setting of a specialized consultation for vitiligo using an anchored-theory method, which allowed conceptualization of the SDMt. The usefulness of the SDMt was evaluated by a working group of multidisciplinary health workers and patients with vitiligo. Consensus on the final tool was obtained through an e-Delphi method. RESULTS: We recruited 30 patients with vitiligo for the qualitative study, which identified 91 topics related to therapeutic decision-making. Hierarchical clustering analysis confirmed the distribution of these topics in two subgroups (general treatment goals and priorities, and topics specific to each treatment). The consensus of a multidisciplinary group was used to develop the SDMt. The tool was comprised of eight A5 cards, which addressed face repigmentation; body repigmentation (limited area); body repigmentation (extended area); partial or complete depigmentation; coping with the disease; stabilization of disease; maintaining repigmentation; and disease information. Cognitive interviews confirmed the satisfaction, readability and usefulness of the SDMt. The SDMt was then translated and culturally validated in English. CONCLUSIONS: We developed a tool for shared decision-making in nonsegmental vitiligo, which we translated and cross-culturally validated in a US patient population with vitiligo to ensure its generalizability.
BACKGROUND: Shared decision-making tools (SDMt) are visual tools developed to promote joint medical decisions between physicians and patients. There is a paucity of such tools in dermatology. OBJECTIVES: To develop and validate a SDMt for use in specialized consultation for vitiligo. METHODS: A prospective cross-sectional study was carried out from March 2019 to March 2020. We first conducted a qualitative study of topics discussed by patients and clinicians during therapeutic decision-making in the setting of a specialized consultation for vitiligo using an anchored-theory method, which allowed conceptualization of the SDMt. The usefulness of the SDMt was evaluated by a working group of multidisciplinary health workers and patients with vitiligo. Consensus on the final tool was obtained through an e-Delphi method. RESULTS: We recruited 30 patients with vitiligo for the qualitative study, which identified 91 topics related to therapeutic decision-making. Hierarchical clustering analysis confirmed the distribution of these topics in two subgroups (general treatment goals and priorities, and topics specific to each treatment). The consensus of a multidisciplinary group was used to develop the SDMt. The tool was comprised of eight A5 cards, which addressed face repigmentation; body repigmentation (limited area); body repigmentation (extended area); partial or complete depigmentation; coping with the disease; stabilization of disease; maintaining repigmentation; and disease information. Cognitive interviews confirmed the satisfaction, readability and usefulness of the SDMt. The SDMt was then translated and culturally validated in English. CONCLUSIONS: We developed a tool for shared decision-making in nonsegmental vitiligo, which we translated and cross-culturally validated in a US patient population with vitiligo to ensure its generalizability.
Authors: Paul Leighton; Joanne R Chalmers; Jonathan M Batchelor; Andy Rogers; Perways Akram; Rachel H Haines; Garry D Meakin; Jennifer White; Jane C Ravenscroft; Tracey H Sach; Miriam Santer; Maxine E Whitton; Viktoria Eleftheriadou; Kim S Thomas Journal: Clin Exp Dermatol Date: 2022-05-30 Impact factor: 4.481