Abstract：
BACKGROUND: Shared decision making (SDM) in surgical specialties was demonstrated to diminish decisional regret, decisional anxiety and decisional conflict. Urolithiasis guidelines do not explicit patient preference to choose treatment. The aim of this review article was to perform a systematic evaluation of published evidence regarding SDM in urinary stone treatment.
METHODS: A systematic review in accordance PRISMA checklist was conducted using the MEDLINE (PubMed) database. Inclusion criteria were studies that evaluated stone treatment preferences. Reviews, editorials, case reports and video abstracts were excluded. ROBUST checklist was used to assess quality of the studies.
RESULTS: 188 articles were obtained. After applying the predefined selection criteria, seven articles were included for final analysis. Six out of seven studies were questionnaires that propose clinical scenarios and treatment alternatives. The last study was a patient preference trial. A general trend among included studies showed a patient preference towards the least invasive option (SWL over URS). The main reasons to choose one treatment over the other were stone-free rates, risk of complications and invasiveness.
CONCLUSIONS: This review provides an overview of the patients\' preferences towards stone treatment in small- and medium-sized stones. There was a clear preference towards the least invasive management strategy. The main reason was less invasiveness. This is opposed to the global trends of performing more ureteroscopies and less SWL. Physicians played a pivotal role in counselling patients. SDM should be encouraged and improved. The main limitation of this study is the characteristics of the included studies.
METHODS: A systematic review in accordance PRISMA checklist was conducted using the MEDLINE (PubMed) database. Inclusion criteria were studies that evaluated stone treatment preferences. Reviews, editorials, case reports and video abstracts were excluded. ROBUST checklist was used to assess quality of the studies.
RESULTS: 188 articles were obtained. After applying the predefined selection criteria, seven articles were included for final analysis. Six out of seven studies were questionnaires that propose clinical scenarios and treatment alternatives. The last study was a patient preference trial. A general trend among included studies showed a patient preference towards the least invasive option (SWL over URS). The main reasons to choose one treatment over the other were stone-free rates, risk of complications and invasiveness.
CONCLUSIONS: This review provides an overview of the patients\' preferences towards stone treatment in small- and medium-sized stones. There was a clear preference towards the least invasive management strategy. The main reason was less invasiveness. This is opposed to the global trends of performing more ureteroscopies and less SWL. Physicians played a pivotal role in counselling patients. SDM should be encouraged and improved. The main limitation of this study is the characteristics of the included studies.
摘要：
背景：外科专业的共享决策（SDM）被证明可以减少决策遗憾，决策焦虑和决策冲突。尿石症指南没有明确患者选择治疗的偏好。这篇综述文章的目的是对已发表的有关SDM在泌尿系结石治疗中的证据进行系统评估。
方法：使用MEDLINE（PubMed）数据库，根据PRISMA检查表进行系统评价。纳入标准是评估结石治疗偏好的研究。评论,社论,病例报告和视频摘要被排除.使用ROBUST检查表评估研究质量。
结果：共获得188篇文献。应用预定义的选择标准后，包括七篇文章进行最终分析。七项研究中有六项是提出临床方案和治疗替代方案的问卷。最后一项研究是患者偏好试验。纳入研究的总体趋势表明，患者倾向于侵入性最小的选择（SWL优于URS）。选择一种治疗方法的主要原因是无结石率，并发症和侵入性的风险。
结论：本综述概述了患者对中小型结石治疗的偏好。显然倾向于侵入性最小的管理策略。主要原因是侵入性较小。这与进行更多输尿管镜检查和更少的SWL的全球趋势相反。医生在咨询患者方面发挥了关键作用。应鼓励和改进SDM。本研究的主要局限性在于纳入研究的特点。
方法：使用MEDLINE（PubMed）数据库，根据PRISMA检查表进行系统评价。纳入标准是评估结石治疗偏好的研究。评论,社论,病例报告和视频摘要被排除.使用ROBUST检查表评估研究质量。
结果：共获得188篇文献。应用预定义的选择标准后，包括七篇文章进行最终分析。七项研究中有六项是提出临床方案和治疗替代方案的问卷。最后一项研究是患者偏好试验。纳入研究的总体趋势表明，患者倾向于侵入性最小的选择（SWL优于URS）。选择一种治疗方法的主要原因是无结石率，并发症和侵入性的风险。
结论：本综述概述了患者对中小型结石治疗的偏好。显然倾向于侵入性最小的管理策略。主要原因是侵入性较小。这与进行更多输尿管镜检查和更少的SWL的全球趋势相反。医生在咨询患者方面发挥了关键作用。应鼓励和改进SDM。本研究的主要局限性在于纳入研究的特点。
