Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit

In the neurological intensive care unit (neuroICU), patients with severe acute brain injury (SABI) are rendered unable to make their own healthcare decisions. The responsibility of making life-or-death decisions, such as goals of care, is carried by surrogate decision-makers, usually families. In ad...

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Main Authors: Winnie L. Liu, Lidan Zhang, Soussan Djamasbi, Bengisu Tulu, Susanne Muehlschlegel
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Neurotherapeutics
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Online Access:http://www.sciencedirect.com/science/article/pii/S1878747924001909
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author Winnie L. Liu
Lidan Zhang
Soussan Djamasbi
Bengisu Tulu
Susanne Muehlschlegel
author_facet Winnie L. Liu
Lidan Zhang
Soussan Djamasbi
Bengisu Tulu
Susanne Muehlschlegel
author_sort Winnie L. Liu
collection DOAJ
description In the neurological intensive care unit (neuroICU), patients with severe acute brain injury (SABI) are rendered unable to make their own healthcare decisions. The responsibility of making life-or-death decisions, such as goals of care, is carried by surrogate decision-makers, usually families. In addition to the burden of decision-making, the emotional burden on families is further compounded by prognostication uncertainty, time-pressure for decision-making, and difficulties in understanding and interpreting the patient's values and preferences, ultimately resulting in potential clinician-family communication breakdown. Despite these challenges, there is currently no guidance on how to best approach these difficult decisions. Shared decision-making (SDM) has emerged as the recommended approach to improve clinician-family communication, empowering surrogates to take an active role in decision-making by providing a structured framework for information exchange, deliberation, and treatment decisions. Decision aids (DAs) facilitate SDM by offering balanced, accessible, unbiased information and helping surrogates decide according to patients' values. This review highlights the potential advantage of digital over paper-based DAs, including improved accessibility, interactivity, and personalization, and the integration of emerging technologies to enhance DA effectiveness. Additionally, we review the current digital DAs developed for the neuroICU setting.
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spelling doaj-art-b99a6073463c4fd69b32701b9ea5e82e2025-02-01T04:11:53ZengElsevierNeurotherapeutics1878-74792025-01-01221e00503Development of web- and mobile-based shared decision-making tools in the neurological intensive care unitWinnie L. Liu0Lidan Zhang1Soussan Djamasbi2Bengisu Tulu3Susanne Muehlschlegel4Johns Hopkins University School of Medicine, Baltimore, MD, USAThe Business School, Worcester Polytechnic Institute, Worcester, MA, USAUser Experience and Decision Making (UXDM) Laboratory, The Business School, Worcester Polytechnic Institute, Worcester, MA, USAThe Business School, Worcester Polytechnic Institute, Worcester, MA, USADepartments of Neurology, Anesthesiology & Critical Care Medicine, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA; Corresponding author.In the neurological intensive care unit (neuroICU), patients with severe acute brain injury (SABI) are rendered unable to make their own healthcare decisions. The responsibility of making life-or-death decisions, such as goals of care, is carried by surrogate decision-makers, usually families. In addition to the burden of decision-making, the emotional burden on families is further compounded by prognostication uncertainty, time-pressure for decision-making, and difficulties in understanding and interpreting the patient's values and preferences, ultimately resulting in potential clinician-family communication breakdown. Despite these challenges, there is currently no guidance on how to best approach these difficult decisions. Shared decision-making (SDM) has emerged as the recommended approach to improve clinician-family communication, empowering surrogates to take an active role in decision-making by providing a structured framework for information exchange, deliberation, and treatment decisions. Decision aids (DAs) facilitate SDM by offering balanced, accessible, unbiased information and helping surrogates decide according to patients' values. This review highlights the potential advantage of digital over paper-based DAs, including improved accessibility, interactivity, and personalization, and the integration of emerging technologies to enhance DA effectiveness. Additionally, we review the current digital DAs developed for the neuroICU setting.http://www.sciencedirect.com/science/article/pii/S1878747924001909Surrogate Decision-MakingGoals of CareSevere Acute Brain Injury (SABI)Digital Decision Aids (DAs)
spellingShingle Winnie L. Liu
Lidan Zhang
Soussan Djamasbi
Bengisu Tulu
Susanne Muehlschlegel
Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
Neurotherapeutics
Surrogate Decision-Making
Goals of Care
Severe Acute Brain Injury (SABI)
Digital Decision Aids (DAs)
title Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
title_full Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
title_fullStr Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
title_full_unstemmed Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
title_short Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit
title_sort development of web and mobile based shared decision making tools in the neurological intensive care unit
topic Surrogate Decision-Making
Goals of Care
Severe Acute Brain Injury (SABI)
Digital Decision Aids (DAs)
url http://www.sciencedirect.com/science/article/pii/S1878747924001909
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