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We all want practical solutions to achieve better care.

Shared Decision Making (SDM) involves patients and their healthcare provides making choices about care together; they consider the current evidence, discuss the potential benefits and risks of each option, enabling the patient to make an informed choice about the next step in their care.

SDM aids are clinical tools that a patient and their provider can use to facilitate this type of discussion. SDM and other tools to facilitate more appropriate care include videos, handouts, apps, and web resources. Some of the most straight-forward and useful ones are collected here.

This section is under development; resources are added regularly.

*HealthyDebate featured a helpful article: Decision aids: why hasn’t this proven, patient-centred practice caught on? It's a good place to start if you are new to this way of cooperating between patient and provider.*

Decision Aids 101 (subscription required) has created a toolkit to give managers the resources they need to help frontline clinicians incorporate patient input into care decisions, i.e. to do shared decision

NEW: The SHARE Approach from the Agency for Healthcare Research and Quality (AHRQ) offers a five-step process for shared decision-making that includes exploring and comparing the benefits, harms, and risks of each option through meaningful dialogue about what matters most to the patient.

Shared Decision Making (SDM) aids, Sample Conversations, Handouts & Videos
 

NON-DISEASE SPECIFIC / CReate your own tool or icon image

 

 

 

 

 

 

Comprehensive DATABASES with disease-specific tools:

Apps

  • Choosing Wisely Canada App [iOS/Google Play App] from Choosing Wisely Canada: contains physician recommendations and patient handouts

  • Tandem Health App [iOS/Android/Web App] (Beta) from Consumer Reports/National Physicians Alliance (NPA): This application was developed by consumers and providers together—for them to use together. It covers care options for the most common medical needs

CANCER SCREENING

  • Testing for Cancer: My Options, My Choice [PDF] from The Centre for Effective Practice: Canadian Guide that walks patients through cancer screening, investigation

  • Risks and Benefits of Breast Cancer Screening [infographic/fact boxes] from The Harding Center for Risk Literacy: a set of infographics created with the results of the Cochrane Systematic Review regarding the utility and benefits/harms of breast cancer screening with mammography

  • Breast Screening Decisions age 40-49: [online decision tool] from Weill Cornell Medical College: a tool that helps women 40-49 decide if mammography benefit may outweigh risks for their profile (based on risk factors)

  • Breast Cancer Screening Decision Aid [online questionnaire] from BC Cancer Agency: a tool that asks 6 simple questions to help a patient decide if the benefits outweigh the risks for screening mammography LIMITATIONS: Doesn't discourage screening for those 40-49, doesn't mention chance of detecting indolent cancers that would never have harmed a person

Cardiovascular

  • Aspirin and statin decision making aid [interactive website], from the Mayo Clinic: an online calculator for use in the office with patient and clinicians to help decide on the appropriateness of statins and ASA for patients to reduce cardiovascular risk

  • Aspirin bleeding risk calculator [interactive website], from the University of Auckland: this calculator provides clinicians with an individualized estimate of the cardiovascular benefit and bleeding harms of aspirin for their patients without established cardiovascular disease

  • The Guidelines Battle on Starting Statins [article with 3 scenarios], from the Lancet: a case approach with three different approaches to deciding whether to start statins for primary prevention

  • Cardiovascular Risk/Benefit Calculator [interactive website], from Therapeutics Education Collaboration: an online/offline calculator is an interactive and individualized tool which provides an absolute estimate (%) of a person's chance of having a cardiovascular event, over a specific period of time and an idea of the potential benefit of specific treatments

  • SPARCTool [online calculator] by Peter Loewen, "Stroke Prevention in Atrial Fibrillation Risk Tool" for estimating risk of stroke and benefits & risks of antithrombotic therapy in patients with chronic atrial fibrillation , incorporates CHADS2/CHA2DS2-VASc and HAS-BLED and shows stats on efficacy/risk of antiplatelets, coumadin, novel anti-coagulants, etc.

Caregiving

  • Should I put my relative with Alzheimer's disease in a nursing home? [PDF] from HealthWise: The decision to put a relative with Alzheimer's disease (or any Dementia) in a nursing home is often a difficult one. Caring for someone with Alzheimer's disease at home requires significant social, financial, and personal sacrifices. Every family has different needs, preferences, and constraints to think about.

Infectious Diseases

  • Antibiotic prescribing fact sheet [PDF] from the CDC: A guide for hospital prescribers to reduce antibiotic overuse in hospitals, in efforts to decrease adverse events including C. difficile and the development of Antibiotic Resistant Organisms (AROs)

MENTAL HEALTH

Musculoskeletal

  • Low Back Pain [video] from Dr Mike Evans: A great video for patients to learn more about the diagnosis and treatment of lower back pain and when imaging is appropriate. Most lower back pain is within your power to manage!

 

 

 

 

 

Obstetrics & Gynecology

  • Prenatal Screening: Is It Right for You? [35 min Video] from the Dartmouth-Hitchcock Norris Cotton Cancer Centre: Are you considering prenatal screening for Down syndrome, neural tube defects and trisomy 18? If so, this video may help you decide whether or not screening is right for you. It shows a range of options and outcomes. Download the companion booklet to this video. LIMITATIONS: Long video, some USA-specific content

  • Prenatal Genetic Screening Program BC - some videos, shared decision-making graphic tool / visual aid tool, pamphlets in multiple languages and a handy FAQ section; with all these various formats, every clinician or patient can find a style of learning tool that can help them work through the decision of whether maternal serum screening is the right choice

 

Palliative Care/GOALS OF CARE

  • Advance Care Planning [PDFs] from the British Columbia Ministry of Health. For information on advance care planning information including videos (Punjabi and Simplified Chinese subtitles available), brochures, tips on completing your advance care plan, or answers to frequently asked questions (including legalese) this provides a pretty comprehensive

  • A Decision Aid about Goals of Care for Patients with Dementia [video, 21 min] from the University of North Carolina at Chapel Hill. Shown to improve end-of-life communication with clinicians: using this tool, clinicians were more likely to address palliative care in treatment plans, use Medical Orders for Scope of Treatment, and were less likely to send patients to the hospital (JAMA Int Med)

    • This decision aid can help to prepare and educate families who must make health care decisions for people with advanced dementia. Family members should view the decision aid before they have a care plan discussion or meet with the patient’s physician.

POLYPHARMACY/Deprescribing:

Radiology

  • Radiology recommendations and clinical decision rules [PDF] from Choosing Wisely Australia (for practitioners) has great algorithms to help patients avoid unnecessary imaging in acute ankle injury, DVT, Pulmonary Embolus, acute lower back pain, c-spine trauma, and head trauma.

  • XRayRisk: Radiation Risk Calculator [Website] from (for patients and practitioners) is a website that allows individuals to calculate their radiation exposure from a given test, such as a CT Abdomen or a Dental x-Ray. It will also show your baseline risk of developing cancer and how this is affected by the scan, plus it allows you to easily add up all the tests you've ever had to calculate the magnitude of your overall exposure.

RENAL

  • RPA SDM Toolkit: [iOS] An App version of the Renal Physicians Association (RPA)'s Shared Decision Making Guideline. It offers nephrologists the tools and recommendations with which they can aid adult and pediatric patients who have AKI, CKD, or ESRD in initiating, withholding and withdrawing dialysis. LIMITATIONS: industry funding is taken by this organization and though not obvious, it may alter the quality of the tool

RESPIRATORY

  • Obstructive Sleep Apnea (OSA) PriDecisionAid [Interactive website] from UBC. This decision aid is designed for adults recently diagnosed with obstructive sleep apnea (OSA). It provides information about OSA and treatment options.

UROLOGY

  • Predict: Prostate Cancer Prognosis Tool: An individualized prognostic model for men newly diagnosed with non-metastatic prostate cancer from NHS. Can be used to discuss and understand harms and benefits of radical prostatectomy, radiation therapy, and conservative management.

Do you know of a great hands-on resource? E-mail the details or tweet them to @LessIsMoreMed