Definitions in Shared Decision-Making
• Are used in conjunction with SDM conversation to assist providers and patients to discuss treatment or
screening options that is preference sensitive in nature
• Contain content that is evidence-based and reviews multiple options that people value differently. Format can
be written, video, web-based, interactive and available through patient portals in EMR’s such as EPIC My Chart.
• Describes risk/benefit of options using stick figures or graphs that patients understand better which reduces the risk of over or under-estimating risk and less realistic expectations.
• Are proven to increase patient knowledge of available treatments, greater patient participation in decision
making and improved patient health status and quality of life (Mayo Center for Innovation)
Decisional conflict is defined as:
Personal uncertainty about which course of action to take when choice among competing options involves risk, regret, or challenge to personal life values.
Preference-sensitive conditions are those in which:
• Alternatives exist with no clear best choice
• Significant trade-offs may exist that affect QOL or length of life
• Require complex decisions that have multiple options with features that people value differently
• Scientific evidence about options is sometimes limited
• The best choice may depend on the personal importance the patient places on the benefits, harms, and
scientific uncertainties- trade-offs
SURE Test – Decisional conflict documentation
(Copyright O’Connor and Légaré, 2008)
Sure of myself – Do you feel SURE about the best choice for you?
Understand information – Do you know the benefits and risks of each option?
Risk benefit ratio – Are you clear about what benefits and risks matter most to you?
Encouragement – Do you have enough support and advice to make a choice?