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Patient Decision Aids to Support Clinical Decision Making: Evaluating the Decision or the Outcomes of the Decision

Author

Listed:
  • Kirsten McCaffery

    (School of Public Health, Univer- sity of Sydney, Sydney, Australia, kirstenm@health.usyd.edu.au)

  • Les Irwig

    (School of Public Health, Univer- sity of Sydney, Sydney, Australia)

  • Patrick Bossuyt

    (Department of Clinical Epidemiology & Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands)

Abstract

Decision aids (DAs) are tools to support patients make informed health decisions with their practitioner. They aim to improve patient knowledge of options, incorporate patient preferences and values, and increase patient involvement in health decision making. Increasingly, the debate about DAs concerns how they should be implemented in practice, with the view that DAs are superior to usual clinical care in facilitating health decisions. The authors challenge this view and suggest that DA research has focused on measures of decision process, leaving the effects on the outcome of the decision relatively unknown. It is still unclear in which conditions DAs are better for patient health and well-being than clinician-led decisions. The authors present a new randomized design to examine the effects of DA-supported patient choice on patient-centered outcomes to identify where DAs are best implemented in clinical practice. In this design, patients are randomized to 1 of 4 arms: intervention A, intervention B, choice of either intervention supported by a clinician, or choice of either intervention supported by a decision aid. Health and quality of life measured over the long term are presented as the primary outcomes. The authors propose that this design will allow the proper assessment of different modes of decision making.

Suggested Citation

  • Kirsten McCaffery & Les Irwig & Patrick Bossuyt, 2007. "Patient Decision Aids to Support Clinical Decision Making: Evaluating the Decision or the Outcomes of the Decision," Medical Decision Making, , vol. 27(5), pages 619-625, September.
    • Handle: RePEc:sae:medema:v:27:y:2007:i:5:p:619-625
    DOI: 10.1177/0272989X07306787
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    References listed on IDEAS

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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
    3. Janevic, Mary R. & Janz, Nancy K. & Dodge, Julia A. & Lin, Xihong & Pan, Wenqin & Sinco, Brandy R. & Clark, Noreen M., 2003. "The role of choice in health education intervention trials: a review and case study," Social Science & Medicine, Elsevier, vol. 56(7), pages 1581-1594, April.
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    Cited by:

    1. repec:cup:judgdm:v:4:y:2009:i:2:p:141-146 is not listed on IDEAS
    2. Victoria A. Shaffer & Lukas Hulsey, 2009. "Are patient decision aids effective? Insight from revisiting the debate between correspondence and coherence theories of judgment," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 4(2), pages 141-146, March.
    3. Anandhi Vivekanandan Dhukaram & Chris Baber, 2016. "A Systematic Approach for Developing Decision Aids: From Cognitive Work Analysis to Prototype Design and Development," Systems Engineering, John Wiley & Sons, vol. 19(2), pages 79-100, March.

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