Medical Decision Making

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here for more information

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Holmes-Rovner, M.
Right arrow Articles by Correa-de-Araujo, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Holmes-Rovner, M.
Right arrow Articles by Correa-de-Araujo, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
This version was published on October 1, 2007
Medical Decision Making, Vol. 27, No. 5, 599-608 (2007)
DOI: 10.1177/0272989X07307272
© 2007 Society for Medical Decision Making

Are Patient Decision Aids the Best Way to Improve Clinical Decision Making? Report of the IPDAS Symposium

Margaret Holmes-Rovner, PhD

College of Human Medicine, Michigan State University, East Lansing, mholmes{at}msu.edu

Wendy L. Nelson, PhD

Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland

Michael Pignone, MD, MPH

University of North Carolina, Chapel Hill

Glyn Elwyn, PhD, FRCGP

Department of Primary Care and Public Health, Cardiff University, UK

David R. Rovner, MD

College of Human Medicine, Michigan State University, East Lansing

Annette M. O'Connor, RN, PhD

Ottawa Health Research Institute and University of Ottawa, Ontario, Canada

Angela Coulter, PhD

Picker Institute Europe, Oxford, UK

Rosaly Correa-de-Araujo, MD, MSc, PhD

Office of Global Health Affairs, Department of Health and Human Services, Rockville, Maryland

This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that ``decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against.

Key Words: Key words: patient decision aids • decision support • decision analysis • evidence-based medicine • values clarification. (Med Decis Making 2007;27:599—608)

References

  • O'Connor AM, Stacey D., Entwistle V., et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2003;(2):CD001431.
  • Barry MJ, Mulley AG, Fowler FJ, Wennberg JW Watchful waiting vs immediate transurethral resection for symptomatic prostatism. JAMA. 1988;259:3010—7.[Abstract]
  • Pauker SG, Kopelman RI How sure is sure enough? N Engl J Med. 1992;326(10):688—91.[ISI][Medline] [Order article via Infotrieve]
  • Barry MJ, Fowler FJ Jr, Mulley AG Jr, Henderson JV Jr, Wennberg JE Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care. 1995;33(8):771—82.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Rothert M., Rovner D., Holmes M., et al. Women's use of information regarding hormone replacement therapy. Res Nurs Health. 1990;13(6):355—66.[ISI][Medline] [Order article via Infotrieve]
  • O'Connor AM Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25—30.[Medline] [Order article via Infotrieve]
  • Kasper JF, Mulley AG Jr, Wennberg JE Developing shared decision-making programs to improve the quality of health care. QRB Qual Rev Bull. 1992;18(6):183—90.[Medline] [Order article via Infotrieve]
  • Novack GD The CONSORT statement for publication of controlled clinical trials. Ocul Surf. 2004;2(1):45—6.[Medline] [Order article via Infotrieve]
  • Agency for Health Care Research and Quality. National Guideline ClearingHouse. 25 March 2007. Available from: URL: http://www.guideline.gov
  • Raiffa H. Decision Analysis: Introductory Lectures on Choices under Uncertainty. Reading (MA): Addison-Wesley; 1968.
  • Pauker SG, Pauker SP Prescriptive models to support decision making in genetics. Birth Defects Orig Artic Ser. 1987;23(2): 279—96.[Medline] [Order article via Infotrieve]
  • Lurie JD, Sox HC Principles of medical decision making. Spine. 1999;24(5):493—8.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Llewellyn-Thomas HA Patients' health-care decision making: a framework for descriptive and experimental investigations. Med Decis Making. 1995;15(2):101—6.[Free Full Text]
  • O'Connor AM, Tugwell P., Wells GA, et al. A decision aid for women considering hormone therapy after menopause: decision support framework and evaluation. Patient Educ Couns. 1998; 33(3):267—79.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Mulley A. Outcomes research: implications for policy and practice. In: Smith R, Delamothe T, eds. Outcomes in Clinical Practice. London: BMJ Publishing; 1995. p 13—27.
  • Charles C., Whelan T., Gafni A. What do we mean by partnership in making decisions about treatment? BMJ. 1999;319(7212): 780—2.[Free Full Text]
  • Degner LF, Sloan JA, Venkatesh P. The Control Preferences Scale. Can J Nurs Res. 1997;29(3):21—43.[Medline] [Order article via Infotrieve]
  • Braddock CH III, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 1999;282(24):2313—20.[Abstract/Free Full Text]
  • Wennberg JE, Barnes BA, Zubkoff M. Professional uncertainty and the problem of supplier-induced demand. Soc Sci Med. 1982; 16(7):811—24.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Wennberg JE, Mulley AG Jr, Hanley D., et al. An assessment of prostatectomy for benign urinary tract obstruction: geographic variations and the evaluation of medical care outcomes. JAMA. 1988;259(20):3027—30.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • The Hastings Center. Making Health Care Decisions. Washington, DC: President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research; 1981.
  • Siegler M. Searching for moral certainty in medicine: a proposal for a new model of the doctor-patient encounter. Bull N Y Acad Med. 1981;57(1):56—69.[Medline] [Order article via Infotrieve]
  • Strull WM, Lo B., Charles G. Do patients want to participate in medical decision making? JAMA. 1984;252(21):2990—4.[Abstract]
  • Emanuel EJ, Emanuel LL Four models of the physician-patient relationship. JAMA. 1992;267(16):2221—6.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Schneider CE The Practice of Autonomy: Patients, Doctors, and Medical Decisions. New York: Oxford University Press; 1998.
  • O'Connor AM, Bennett C., Stacey D., et al. Do patient decision aids meet effectiveness criteria of the International Patient Decision Aid Standards collaboration? A systematic review and meta-analysis. Med Decis Making. 2007;27(5):554—74.[Abstract/Free Full Text]
  • Kassirer J. Incorporating patients' preferences into medical decisions. N Engl J Med. 1994;330(26):1895—6.[Free Full Text]
  • Elwyn G., O'Connor A., Stacey D., et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333(7565):417.[Abstract/Free Full Text]
  • Jones J., Hunter D. Using the Delphi and nominal group technique in health services research. In: Mays N, Pope C, eds. Qualitative Research in Health Care. London: BMJ Books; 1999.
  • Complete list of OHRI decision aids. Ontario Health Research Institute. 31 January 2007. Available from: URL: http://ipdas.ohri.ca/resources.html
  • Sepucha KR, Fowler FJ Jr, Mulley AG Jr. Policy support for patient-centered care: the need for measurable improvements in decision quality. Health Aff (Millwood). 2004;(Suppl Web Exclusive):VAR54—62.
  • Dijksterhuis A. Think different: the merits of unconscious thought in preference development and decision making. J Pers Soc Psychol. 2004;87(5):586—98.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Dijksterhuis A., Bos MW, Nordgren LF, van Baaren RB. On making the right choice: the deliberation-without-attention effect. Science. 2006;311(5763):1005—7.[Abstract/Free Full Text]
  • Wilson TD, Schooler JW Thinking too much: introspection can reduce the quality of preferences and decisions. J Pers Soc Psychol. 1991;60(2):181—92.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Tordesillas RS, Chaiken S. Thinking too much or too little? The effects of introspection on the decision making process. Pers Soc Psychol Bull. 1999;199(25):623—9.
  • Nelson WL, Han Pkj, Fagerlin A, Stefanek MUPA. Rethinking the objectives of decision aids: a call for conceptual clarity. Med Decis Making. 2007;27(5):609—18.[Abstract/Free Full Text]
  • Gladwell M. Blink. New York: Little Brown & Company; 2005.
  • O'Connor AM, Fiset V., DeGrasse C., et al. Decision aids for patients considering options affecting cancer outcomes: evidence of efficacy and policy implications. J Natl Cancer Inst Monogr. 1999;(25):67—80.[Abstract/Free Full Text]
  • O'Connor AM, Stacey D., Entwistle V., et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2003;(2):CD001431.
  • Charles C., Gafni A., Whelan T., O'Brien MA Treatment decision aids: conceptual issues and future directions. Health Expect. 2005;8(2):114—25.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Lichtenstein S, Slovic P, eds. The Construction of Preference. Cambridge (UK): Cambridge University Press; 2006.
  • Payne JW, Bettman JR Behavioral decision research: a constructive processing perspective. Annu Rev Psychol. 1992;43:87—131.[CrossRef][ISI]
  • Rutten-van Molken MP, Bakker CH, van Doorslaer EK, van der LS. Methodological issues of patient utility measurement: experience from two clinical trials. Med Care. 1995;33(9):922—37.[ISI][Medline] [Order article via Infotrieve]
  • Elkin EB, Cowen ME, Cahill D., Steffel M., Kattan MW Preference assessment method affects decision-analytic recommendations: a prostate cancer treatment example. Med Decis Making. 2004;24(5):504—10.[Abstract]
  • Hornberger JC, Redelmeier DA, Petersen J. Variability among methods to assess patients' well-being and consequent effect on a cost-effectiveness analysis. J Clin Epidemiol. 1992;45(5):505—12.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Deber RB, Kraetschmer N., Irvine J. What role do patients wish to play in treatment decision making? Arch Intern Med. 1996;156 (13):1414—20.[Abstract]
  • Dowie J. The role of patients' meta-preferences in the design and evaluation of decision support systems. Health Expect. 2002; 5(1):16—27.[CrossRef][Medline] [Order article via Infotrieve]
  • Ende J., Kazis L., Ash A., Moskowitz MA Measuring patients' desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med. 1989;4(1): 23—30.[ISI][Medline] [Order article via Infotrieve]
  • Whitney SN, Hawley ST, Volk RJ How should physicians involve patients in medical decisions? JAMA. 2000;283(18): 2391—2.[ISI][Medline] [Order article via Infotrieve]
  • Murray E., Davis H., Tai SS, Coulter A., Gray A., Haines A. Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care. BMJ. 2001; 323(7311):493—6.[Abstract/Free Full Text]
  • Legare F., O'Connor AM, Graham ID, et al. Primary health care professionals' views on barriers and facilitators to the implementation of the Ottawa Decision Support Framework in practice. Patient Educ Couns. 2006;63(3):380—90.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Davis D., O'Brien MA, Freemantle N., Wolf FM, Mazmanian P., Taylor-Vaisey A. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999;282(9):867—74.[Abstract/Free Full Text]
  • Greenfield S., Kaplan S., Ware JE Expanding patient involvement in care. Ann Intern Med. 1985;102:520—8.[ISI][Medline] [Order article via Infotrieve]
  • Edwards A., Elwyn G., Wood F., Atwell C., Prior L., Houston H. Shared decision making and risk communication in practice: a qualitative study of GPs' experiences. Br J Gen Pract. 2005;55 (510):6—13.[ISI][Medline] [Order article via Infotrieve]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Med Decis MakingHome page
R. L. Street JR
Aiding Medical Decision Making: A Communication Perspective
Med Decis Making, October 1, 2007; 27(5): 550 - 553.
[PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Holmes-Rovner, M.
Right arrow Articles by Correa-de-Araujo, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Holmes-Rovner, M.
Right arrow Articles by Correa-de-Araujo, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?