Shared Decision-Making

Shared decision-making is a style of counseling in which the health care provider communicates to the patient personalized information about the options, outcomes, probabilities, and scientific uncertainties of available treatment options and the patient communicates his or her values and the relative importance he or she places on benefits and harms. Shared decision-making has been widely advocated as an effective means for reaching agreement on the best strategy for treatment.

Medical decisions have two components: a technical component, which requires knowledge of the risks, benefits, and side effects associated with each treatment option, and a value component, which requires input from the patient about his or her goals, concerns, values, and preferences.
Unfortunately, patients often made decisions about medical treatments without complete understanding of their options. Instead, health care providers may encourage patients to make a particular choice or may not present complete and balanced information on all viable options. It’s important for patients to understand that options exist for almost every treatment decision—including the option to do nothing.

Incorporating patient input is essential for decisions about preference-sensitive conditions—those for which two or more valid treatment choices are available for most patients. Chronic back pain, early-stage breast cancer, early stage prostate cancer, and benign prostatic hypertrophy are considered preference-sensitive conditions. Treatment choices for these conditions should be made by well-informed patients who base their decisions on the best available evidence as well as their personal values and preferences. Ideally, the process for medical decision-making includes input from both the health care provider and the patient. However, in practice, treatment decisions, especially about preference-sensitive conditions, often are determined by local physician practice patterns rather than patient-related factors.

True shared decision-making requires three key elements: a patient who is fully informed about the risks and benefits of all viable options, an involved patient (and family members, if appropriate), and a shared process that involves both health care provider and patient.

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The Foundation for Informed Medical Decision-making offers these definitions to provide context for the topic areas
and a deeper understanding of the referenced articles within each topic.