Redefining shared decision-making in the digital era

Abstract

Perioperative shared decision-making can be improved through the development of novel patient-centered outcome measures made possible by digital phenotyping-"the moment-by-moment quantification of individual-level human phenotype in situ using data from personal digital devices, in particular smartphones." This Short Report presents data from a patient with breast cancer that illustrates the opportunities of digital phenotyping to better inform patient quality of life while also discussing the challenges to its adoption. With time, effort, and physician engagement, digital phenotyping can help surgeons better understand the patient experience in the postoperative period and in turn, help them provide care that maximizes patient quality of life.

Keywords: Breast cancer; Digital health; Quality of life; Shared decision-making; Smartphones.

Figure 1.

Postoperative experience for a single patient undergoing excisional breast biopsy followed by bilateral mastectomy for breast cancer. The top panel shows changes in the patient’s daily activity in minutes during multiple clinical events as measured by smartphone accelerometer data. Self-reported pain and emotional role quality of life scores are graphed below (higher scores indicate more favorable health states).