EDITORIAL COMMENT

Abstract

The authors have provided a unique perspective on the management vesicoureteral reflux (VUR) that incorporates parental preferences regarding various aspects of treatment options. They utilized an innovative, crowd-sourced approach to recruit a national sample of parents online who presumably did not have any “real-world” experience with VUR. Many readers may question whether the wisdom of crowds should supplant the experience of those who have actually dealt with a given scenario in their own children. Previous studies in political science, economics, and psychology, however, have confirmed the external and internal validity of a similar approach to subject recruitment. 1 Berinsky AJ H.G. Lenz J.S. Evaluating online labor markets for experimental research: Amazon.com's mechanical turk. Polit Anal. 2012; 20: 351-368 Google Scholar , 2 Buhrmester MD K.T. Gosling S.D. Amazon's mechanical turk: a new source of inexpensive, yet high-quality, data?. Perspect Psychol Sci. 2011; 6: 3-5 Google Scholar , 3 Horton JJ R.D. Zeckhauser R.J. The online laboratory: conducting experiments in a real labor market. Exp Econ. 2011; 14: 399-425 Google Scholar In addition, the description of a “preference model” in the current study is a precursor to the development of a decision aid for parents of children with VUR. The authors have presented a type of “values clarification exercise” that the International Patient Decision Aids Collaboration considers a key component of patient decision aids. 4 Sepucha K.R. Abhyankar P. Hoffman A.S. Bekker H.L. LeBlanc A. Levin C.A. et al. Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist. BMJ Qual Saf. 2018; 27: 380-388 Crossref PubMed Scopus (93) Google Scholar Decision aids are tools designed to help people make informed, values-based choices about their healthcare options in partnership with their providers. 5 Volk R.J. Coulter A. Advancing the science of patient decision aids through reporting guidelines. BMJ Qual Saf. 2018; 27: 337-339 Crossref PubMed Scopus (9) Google Scholar Shared decision-making represents the state of the art in counseling patients faced with difficult or uncertain medical decisions and its implementation has been widely encouraged by The American Urologic Association. 6 Makarov DV C.K. Gore J.L. Maranchie J. Nielson M.E. Saigal C. Tessier C. Fagerlin A. AUA white paper on implementation of shared decision making into Urological practice. Urol Pract. 2016; 3: 355-363 Google Scholar The current study is an important contribution to the pediatric urologic literature because it will have future implications for the dissemination of shared decision-making and the development of decision aids in our field.