The Informed Medical Decisions Foundation is currently working to expand the international reach of our decision aids with a number of exciting localization projects currently in the works with our partner Bupa and other international colleagues. Three academic groups in French-speaking countries are working with our staff to develop a study to evaluate the use of decision aids for prostate cancer screening.
The updated Cochrane Collaborative review of 86 randomized control trials (in six countries), involving 34 decisions, set out to find out how well decision aids prepare people to participate in decisions that involve weighing benefits, harms and scientific uncertainty. What the authors found was that decision aids not only improve the individual’s knowledge of their options, including the benefits and harms of those options, but decision aids also assist people in reaching choices that are more consistent with their informed values, while fostering collaboration with their provider.
The Ottawa Personal Decision Guide (OPDG) is a general decision aid tool that can be used for any medical decision.
The IPDAS collaboration consists of international researchers, practitioners and stakeholders working to establish an internationally approved set of criteria for patient decision aid quality.
This article describes a study that found that patients with cancer who viewed a video of various goals-of-care options, in addition to a verbal description were more likely to prefer comfort measures and avoid CPR. The study found that these patients were also more knowledgeable regarding advanced care treatment options and felt more certain about their decision compared to patients only hearing a verbal narrative. This article differs from some other studies regarding decision aids since other uses of video decision support tools have focused on helping people make treatment or screening decisions, whereas this video was used to initiate end-of-life discussions.
This is the most comprehensive review article that examines evidence of patient decision aids from numerous randomized control trials and provides a strong evidence base for the positive benefits of patient decision aids. The review finds that when patients use decision aids they: a) improve their knowledge of the options b) have more accurate expectations of possible benefits and harms c) reach choices that are more consistent with their informed values and d) participate more in decision making.
An introduction for health care providers on shared decision making and patient decision aids.
The strongest argument for shared decision making is that patients have a fundamental right to understand all the reasonable medical options and the arguments for and against each option. Simply put, informing and involving patients in medical decisions is the right thing to do. By being informed and involved, patients have the ability to avoid having surgery that exposes them to risks they do not think are worth the benefits. In addition to those certain benefits, the evidence is also mounting that shared decision making is likely to pay for itself -- and it may well do better than that.
This study will advance the evidence base regarding best methods for facilitating informed decisions among patients with knee and hip osteoarthritis (OA) by comparing DVD and Crossroads online formats of decision aids (DAs) for these conditions.
The International Patient Decision Aid Standards (IPDAS) Collaboration has led to the development of a quality checklist and, more recently, an instrument to assess the quality of decision support interventions. We recognize that further work is required to examine the relationships between International Patient Decision Aid Standards instrument (IPDASi) scores and the outcomes achieved in clinical trials.
Dartmouth-Hitchcock Medical Center (DHMC) is comprised of physicians, specialists and other providers working together at different locations to meet the health care needs of patients in northern New England. The Center for Shared Decision Making (CSDM) at DHMC, opened its doors in 1999 as the first center in the U.S. to be dedicated to shared decision making, and became a Foundation funded primary and specialty care demonstration site at that time. True pioneers in the shared decision making arena, DHMC continues to perfect the process of providing access to decision aids and decision support to patients as a routine process of care.
The University of California San Francisco (UCSF) Breast Care Center (BCC) is a high volume specialty clinic providing multi-disciplinary care in a National Cancer Institute-designated Comprehensive Cancer Center. Eight medical oncologists and four surgeons, among dozens of specialists, providers and staff conduct more than 1,000 consultations annually, caring for more than 600 newly diagnosed patients each year. The Breast Care Center at UCSF became a Foundation funded specialty care demonstration site in 2005 in order to offer their patients a unique type of decision support and guidance along their journey.