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Sandberg DE , Gardner M , Kopec K , Urbanski M , Callens N , Keegan CE , Yashar BM , Fechner PY , Shnorhavorian M , Vilain E , Timmermans S , Siminoff LA
Development of a decision support tool in pediatric Differences/Disorders of Sex Development
Semin Pediatr Surg. 2019 Oct;28(5) :150838
PMID: 31668291   
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Abstract
Decisions about how best to clinically care for young children born with Disorders of Sex Development (DSD) can be challenging because some decisions are irreversible, have lasting physical and mental health effects, and are frequently made before the affected person is able to participate in decision-making. This multi-stage study involved (1) the development of a web-based decision support tool (DST) for parents of infants or young children and the clinicians caring for them; (2) the assessment of communications and decision making between DSD specialists and parents both before and after introduction of the DST; and (3) interviews with a broad range of stakeholders regarding optimizing the DST and integrating it into usual care. Experience over the course of the 3 stages of this research suggests the need for further refinement of the DST to increase acceptability to all stakeholder groups, the necessity to address misperceptions by providers that they are already accomplishing all aspects of SDM in regular care without a DST and misunderstandings by parents that decisions are unnecessary because only a single option is apparent, and to better incorporate the tool into regular clinic workflow.
Notes
1532-9453 Sandberg, David E Gardner, Melissa Kopec, Kristin Urbanski, Megan Callens, Nina Keegan, Catherine E Yashar, Beverly M Fechner, Patricia Y Shnorhavorian, Margarett Vilain, Eric Timmermans, Stefan Siminoff, Laura A Journal Article United States Semin Pediatr Surg. 2019 Oct;28(5):150838. doi: 10.1016/j.sempedsurg.2019.150838. Epub 2019 Sep 13.