Healthy Skepticism Library item: 11116

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Montori VM, Breslin M, Maleska M, Weymiller AJ.
Creating a Conversation: Insights from the Development of a Decision Aid
PLoS Medicine 2007 Aug 7; 4:(8):e233
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040233

Abstract:

Evidence-based medicine requires that clinical decisions be consistent not only with the best available research evidence, but with the values and preferences of the informed patient [1]. To achieve this goal, clinicians and patients can use tools, known as decision aids, that prepare patients for decision making [2] or help clinicians assist patients in participating in making decisions [3].

Our research group has recently completed the development and testing of such a decision aid, dubbed Statin Choice, for patients with diabetes who were considering using statins (medications that lower cholesterol) to reduce their cardiovascular risk. Statin Choice sought both to help clinicians share the evidence about potential benefits and downsides of statins and to create a two-way conversation that would enable patients to participate in making decisions to the extent they preferred. Patients’ participation could make the resulting decisions more likely to be consistent with their values and preferences. In addition, patient participation in decision making (i.e., cognitive investment in the decision and thus “ownership” of that decision) could enhance adherence to therapeutic interventions, among other potential benefits.

Here, we present the insights that resulted from the process we followed to develop this decision aid. In sharing these insights, our intent is not prescriptive (i.e., “this is how you should develop decision aids”), but rather to inspire others to seek innovative, yet goal-directed approaches to the development of decision aids that are not only evidence-based in content but also user-centered in their design and use…