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April 2021; 11 (2) Review

Shared Decision‐making in Autoimmune Neurology

Making Decisions in the Face of Uncertainty

David A. Lapides
First published December 11, 2019, DOI: https://doi.org/10.1212/CPJ.0000000000000796
David A. Lapides
Department of Neurology, University of Virginia, Charlottesville, VA.
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Shared Decision‐making in Autoimmune Neurology
Making Decisions in the Face of Uncertainty
David A. Lapides
Neurol Clin Pract Apr 2021, 11 (2) 141-146; DOI: 10.1212/CPJ.0000000000000796

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Abstract

Purpose of review In this article, the author explores the use of shared decision making (SDM) in the management of the preference-sensitive condition, neural autoantibody-mediated syndromes.

Recent findings The field of autoimmune neurology lacks trials and often data to support therapeutic decisions. Treatment choices need to be made acutely, lacking crucial laboratory information and with uncertainty regarding treatment response and prognosis. This lack of data does not necessitate indecision in a population where delayed treatment may lead to poor outcomes. Over the past several decades, SDM has emerged as a model of communication enabling clinicians and their patients to explore current knowledge in the context of a patient's values and goals to arrive at joint decision, even when data are lacking.

Summary SDM is a tool autoimmune neurologists should use to develop individualized treatment plans based on the patient's clinical presentation contextualized within specific values and preferences.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Editorial, page 93

  • Received August 6, 2019.
  • Accepted November 18, 2019.
  • © 2019 American Academy of Neurology
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