TY - JOUR
T1 - Rethinking the objectives of decision aids
T2 - A call for conceptual clarity
AU - Nelson, Wendy L.
AU - Han, Paul K.J.
AU - Fagerlin, Angela
AU - Stefanek, Michael
AU - Ubel, Peter A.
PY - 2007/9
Y1 - 2007/9
N2 - Health decision aids are a potentially valuable adjunct to patient-physician communication and decision making. Although the overarching goal of decision aids- to help patients make informed, preference-sensitive choices-is widely accepted, experts do not agree on the means to achieve this end. In this article, the authors critically examine the theoretical basis and appropriateness of 2 widely accepted criteria used to evaluate decision aids: values clarification and reduction of decisional conflict. First, they argue that although clarifying values is central to decision making under uncertainty, it is not clear that decision aids-as they have been conceived and operationalized so far-can and should be used to achieve this goal. The pursuit of clarifying values, particularly values clarification exercises, raises a number of ethical, methodological, and conceptual issues, and the authors suggest research questions that should be addressed before values clarification is routinely endorsed. Second, the authors argue that the goal of reducing decisional conflict is conceptually untenable and propose that it be eliminated as an objective of decision aids.
AB - Health decision aids are a potentially valuable adjunct to patient-physician communication and decision making. Although the overarching goal of decision aids- to help patients make informed, preference-sensitive choices-is widely accepted, experts do not agree on the means to achieve this end. In this article, the authors critically examine the theoretical basis and appropriateness of 2 widely accepted criteria used to evaluate decision aids: values clarification and reduction of decisional conflict. First, they argue that although clarifying values is central to decision making under uncertainty, it is not clear that decision aids-as they have been conceived and operationalized so far-can and should be used to achieve this goal. The pursuit of clarifying values, particularly values clarification exercises, raises a number of ethical, methodological, and conceptual issues, and the authors suggest research questions that should be addressed before values clarification is routinely endorsed. Second, the authors argue that the goal of reducing decisional conflict is conceptually untenable and propose that it be eliminated as an objective of decision aids.
KW - Decision aids
KW - Decision making
KW - Decisional conflict
KW - Values clarification
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U2 - 10.1177/0272989X07306780
DO - 10.1177/0272989X07306780
M3 - Article
C2 - 17873251
AN - SCOPUS:35148812508
SN - 0272-989X
VL - 27
SP - 609
EP - 618
JO - Medical Decision Making
JF - Medical Decision Making
IS - 5
ER -