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Factors influencing decision making in neonatology: inhaled nitric oxide in preterm infants
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نویسنده
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Manja Veena ,Guyatt Gordon ,Lakshminrusimha Satyan ,Jack Susan ,Kirpalani Haresh ,Zupancic John A. F. ,Dukhovny Dmitry ,You John J. ,Monteiro Sandra
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منبع
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journal of perinatology - 2019 - دوره : 39 - شماره : 1 - صفحه:86 -94
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چکیده
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Objective:we studied decision making regarding inhaled nitric oxide (ino) in preterm infants with pulmonary hypertension (ph).study design:we asked members of the aap-society of neonatal-perinatal medicine and division-chiefs to select from three management options- initiate ino, engage parents in shared decision making or not consider ino in an extremely preterm with ph followed by rating of factors influencing their decision.results:three hundred and four respondents (9%) completed the survey; 36.5% chose to initiate ino, 42% to engage parents, and 21.5% did not consider ino. provider’s prior experience, safety, and patient-centered care were rated higher by those who initiated or offered ino; lack of effectiveness and cost considerations by participants who did not chose ino.conclusions:most neonatologists offer or initiate ino therapy based on their individual experience. the minority who chose not to consider ino placed higher value on lack of effectiveness and cost. these results demonstrate a tension between evidence and pathophysiology-based-therapy/personal experience.
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آدرس
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University of California at Davis, Departments of Surgery and Pediatrics, USA. McMaster University, Department of Health Research Methods, Canada, McMaster University, Department of Health Research Methods, Canada, University of California at Davis, Departments of Surgery and Pediatrics, USA. UC Davis Medical Center, Department of Pediatrics, USA, McMaster University, Department of Health Research Methods, Canada, McMaster University, Department of Health Research Methods, Canada. University of Pennsylvania School of Medicine, USA, Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Neonatology, USA, Oregon Health and Science University, Department of Pediatrics, USA, McMaster University, Department of Health Research Methods, Department of Medicine, Canada, McMaster University, Department of Health Research Methods, Canada
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Authors
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