A new paradigm for esophageal disease management: the application and future prospects of Shared Decision Making (SDM)

Abstract

Shared Decision Making (SDM), as a “patient-centered” medical decision-making model, has gradually demonstrated its application value in the diagnosis and treatment of esophageal diseases. This study is a structured narrative review (without quantitative synthesis or heterogeneity assessment). This structured narrative review systematically searched databases including PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) from 1990 to 2026 for clinical studies, meta-analyses, and guideline documents related to SDM in the field of esophageal diseases.It clarified the application scenarios and implementation pathways of SDM in major esophageal diseases such as esophageal cancer and gastroesophageal reflux disease. especially focusing on surgical decision-making in esophageal cancer.Meanwhile, based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, this study critically analyzed the advantages of SDM in enhancing patient decision-making satisfaction, optimizing the doctor-patient relationship, and formulating individualized treatment plans. It also objectively expounded on real-world challenges, including the lag in physicians’ conceptual transformation, variations in patients’ ability to participate, and limitations in medical resources. This study innovatively constructed a three-dimensional SDM implementation framework of “disease classification - evidence hierarchy - patient preference” and proposed differentiated application strategies tailored to the clinical characteristics of different esophageal diseases. The research findings provide evidence-based support for the standardized application of SDM in clinical practice for esophageal diseases and lay a foundation for clarifying future research directions in this field.