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Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury

BACKGROUND: There is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes. We explored the prio...

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Autores principales: Thomas, Rae, Scott, Anna Mae, Sims, Rebecca, Craig, Louise, Claase, Leigh‐Anne, Lowe, Julia, Heal, Clare, Hardiman, Leah, Glasziou, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321745/
https://www.ncbi.nlm.nih.gov/pubmed/32090415
http://dx.doi.org/10.1111/hex.13036
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author Thomas, Rae
Scott, Anna Mae
Sims, Rebecca
Craig, Louise
Claase, Leigh‐Anne
Lowe, Julia
Heal, Clare
Hardiman, Leah
Glasziou, Paul
author_facet Thomas, Rae
Scott, Anna Mae
Sims, Rebecca
Craig, Louise
Claase, Leigh‐Anne
Lowe, Julia
Heal, Clare
Hardiman, Leah
Glasziou, Paul
author_sort Thomas, Rae
collection PubMed
description BACKGROUND: There is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes. We explored the priorities and preferences of women potentially impacted by a GDM diagnosis. METHOD: We recruited 15 women from the Gold Coast, Australia, to participate in a pilot community jury (CJ). Over two days, the women deliberated on the following: (a) which important consequences of a diagnosis of GDM should be considered when defining GDM?; (b) what should Australian health practitioners call the condition known as GDM? RESULTS: Eight women attended the pilot CJ, and their recommendations were a consensus. Women were surprised that the level of risk for physical harms was low but emotional harms were high. The final ranking of important consequences (high to low) was as follows: women's negative emotions; management burden of GDM; overmedicalized pregnancy; minimizing infant risks; improving lifestyle; and macrosomia. To describe the four different clinical states of GDM, the women chose three different labels. One was GDM. CONCLUSIONS: The women from this pilot CJ prioritized the consequences of a diagnosis of GDM differently from clinicians. The current glucose threshold for GDM in Australia is set at a cut‐point for adverse risks including macrosomia and neonatal hyperinsulinaemia. Definitions and guideline panels often fail to ask the affected public about their values and preferences. Community voices impacted by health policies should be embedded in the decision‐making process.
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spelling pubmed-73217452020-06-30 Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury Thomas, Rae Scott, Anna Mae Sims, Rebecca Craig, Louise Claase, Leigh‐Anne Lowe, Julia Heal, Clare Hardiman, Leah Glasziou, Paul Health Expect Original Research Papers BACKGROUND: There is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes. We explored the priorities and preferences of women potentially impacted by a GDM diagnosis. METHOD: We recruited 15 women from the Gold Coast, Australia, to participate in a pilot community jury (CJ). Over two days, the women deliberated on the following: (a) which important consequences of a diagnosis of GDM should be considered when defining GDM?; (b) what should Australian health practitioners call the condition known as GDM? RESULTS: Eight women attended the pilot CJ, and their recommendations were a consensus. Women were surprised that the level of risk for physical harms was low but emotional harms were high. The final ranking of important consequences (high to low) was as follows: women's negative emotions; management burden of GDM; overmedicalized pregnancy; minimizing infant risks; improving lifestyle; and macrosomia. To describe the four different clinical states of GDM, the women chose three different labels. One was GDM. CONCLUSIONS: The women from this pilot CJ prioritized the consequences of a diagnosis of GDM differently from clinicians. The current glucose threshold for GDM in Australia is set at a cut‐point for adverse risks including macrosomia and neonatal hyperinsulinaemia. Definitions and guideline panels often fail to ask the affected public about their values and preferences. Community voices impacted by health policies should be embedded in the decision‐making process. John Wiley and Sons Inc. 2020-02-23 2020-06 /pmc/articles/PMC7321745/ /pubmed/32090415 http://dx.doi.org/10.1111/hex.13036 Text en © 2020 The Authors Health Expectations published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Thomas, Rae
Scott, Anna Mae
Sims, Rebecca
Craig, Louise
Claase, Leigh‐Anne
Lowe, Julia
Heal, Clare
Hardiman, Leah
Glasziou, Paul
Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title_full Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title_fullStr Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title_full_unstemmed Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title_short Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
title_sort exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: a pilot community jury
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321745/
https://www.ncbi.nlm.nih.gov/pubmed/32090415
http://dx.doi.org/10.1111/hex.13036
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