What are examples of clinical decision aids?
by Daniel J. Power
A decision aid is a tool that assists a person in making a specific decision. For example, a highway map is a decision aid for trip planning and for making navigation decisions during the trip. Computing a moving average of sales from previous weeks is a sales forecasting decision aid. Clinical decision aids assist in making medical decisions by clinicians, medical staff and patients. Patient decision aids are designed to help patients with certain conditions think about what is important to them when talking with their clinician (AHRQ, 2016).
According to O'Connor (2001), "Decision aids help patients to participate with their practitioners in making deliberative, personalised choices among healthcare options. ... Decision aids are delivered as self administered tools or practitioner administered tools in one to one or group sessions. Possible media include decision boards, interactive videodiscs, personal computers, audiotapes, audio guided workbooks, and pamphlets."
Clinical and patient decision aids as well as clinical decision support systems provide the greatest benefit when matched with decision making styles and decision tasks (Fiks, 2011; O'Connor, 2001). Healthcare decisions are made in 3 ways: (1) unilaterally by an expert clinician or clinical team that makes treatment decisions and communicates them to the patient; (2) informed patient where patients reach their own healthcare decisions with information from clinicians or other sources; and (3) shared decision-making (SDM) where discussion of options and medical and personal information exchange occurs between clinicians and families (Charles, et al., 1997; Fiks, 2011). Alston et al. (2014) argue "One way to promote SDM is to provide patients and clinicians with well-designed and structured decision aids, which are tools intended to provide detailed, balanced, evidence-based information about competing treatment options. (p. 4)"
The Mayo Clinic Shared Decision Making National Resource Center philosophy states decision aids are "tools to share information and create a conversation about the options and their relative merits and downsides." The disclaimer states "No decision aid replaces the conversation patients should have with their clinicians to make important, clinical decisions."
Agency for Healthcare Research and Quality (AHRQ), "Patient Decision Aids," last accessed May 20, 2016 at URL http://effectivehealthcare.ahrq.gov/index.cfm/tools-and-resources/patient-decision-aids/
Alston, C., Z. Berger, S. Brownlee, G. Elwyn, F. Fowler Jr., L. Kelly Hall, V. Montori, B. Moulton, L. Paget, B. Shebel, R. Singerman, J. Walker, M. Wynia, and D. Henderson. 2014. Shared DecisionMaking Strategies for Best Care: Patient Decision Aids. Discussion Paper, Institute of Medicine, Washington, DC. http://nam.edu/wp-content/uploads/2015/06/SDMforBestCare2.pdf.
Charles, C., A. Gafni, and T. Whelan, "Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango)," Social Science Medicine, 1997;44:681–92 at URL http://www.ncbi.nlm.nih.gov/pubmed/9032835.
Fiks, A. G., "Designing Computerized Decision Support That Works for Clinicians and Families," Current Problems in Pediatric Adolescent Health Care, 2011 Mar; 41(3): 60–88 at URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373310/.
Little, R.G., T. Manzanares and W. A. Wallace, "Factors Influencing the Selection of Decision Support Systems for Emergency Management: An Empirical Analysis of Current Use and User Preferences," Journal of Contingencies and Crisis Management Volume 23, Issue 4, pages 266–274, December 2015. at URL http://onlinelibrary.wiley.com/doi/10.1111/1468-5973.12097/abstract .
Kassirer, J.P., "Incorporating patient preferences into medical decisions," New England Journal of Medicine Volume 330 (26), 1994, pp. 1895-1896.
Mayo Clinic Shared Decision Making National Resource Center at URL http://shareddecisions.mayoclinic.org/
Mayo Clinic Center for Innovation, "Decision Aids," at URL http://www.mayo.edu/center-for-innovation/projects/decision-aids
Montori. V. M., M. Breslin, M. Maleska, and A.J. Weymiller, "Creating a conversation: Insights from the development of a decision aid," PLoS Medicine, 2007;4(8):233 at URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1939861/.
O'Connor, A., "Using patient decision aids to promote evidence-based decision making," Evidence Based Medicine, Volume 6, Issue 4, 2001, pp. 100-102 at URL http://ebm.bmj.com/content/6/4/100.full
Olson, D. L., Decision Aids for Selection Problems, Springer Series in Operations Research and Financial Engineering, 1996.
Last update: 2016-05-27 08:45
Author: Daniel Power
You cannot comment on this entry