Deciding on the location for receiving parenteral antimicrobial therapy: development and preliminary testing of a patient decision aid
Bibliographic record
Abstract
BACKGROUND: Adult patients who need further treatment with parenteral antimicrobial therapy after a stay in the emergency department could be involved in the decision about the location of treatment. Although patients often get admitted to hospitals for parenteral antimicrobial therapy, they can also receive it in their home with different support. Therefore, this study aimed to develop and alpha test a patient decision aid to support patient involvement in this decision. METHODS: A systematic development process was guided by the Ottawa Decision Support Framework. This process included developing a patient decision aid and conducting individual interviews with Danish patients and healthcare professionals to test the comprehensibility, acceptability, and usability of the aid. Directed content analysis guided the analysis. RESULTS: An in-consult 2-page patient decision aid was developed to fit the busy environment of the emergency department. It included (a) a title specifying the decision; (b) information on the treatment, three options, advantages and disadvantages of the options; (c) a value clarification exercise; and (d) a question about preferred option. The patient decision aid met the qualifying criteria of the International Standards for Decision Aids. Participants’ feedback on the comprehensibility was positive, indicating explicit and clear options, and minor suggestions for editing. The healthcare professionals were reserved when asked about the acceptance and usefulness of the patient decision aid because the three options were not considered equal and were difficult to offer due to limited resources. The patients were also skeptical that their preferences could be considered in the decision-making, and they expressed uncertainty about whether treatment at home was as safe as hospitalization. The healthcare professionals recognized the importance of shared decision-making. However, the implementation of the decision aid would necessitate specific competencies, and identification of the best time to introduce it to patients. CONCLUSIONS: Using a systematic process, a patient decision aid was developed. Comprehensive findings revealed that the decision aid could be useful in supporting shared decision-making and in clarifying the available options. However, for the decision aid to be implemented, there needs to be a clear context and training of healthcare professionals in shared decision-making.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.045 | 0.081 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".