Decision support aids
Decision support aids should include several different elements:
- tailored information about medical conditions and treatment options
- information about the outcomes, benefits and risks, including probabilities
- material that helps patients to explore and articulate what, for them personally, is most important (values clarification)
- other patients' descriptions of their experience of making the same or similar decisions
- information and exercises that prepare patients for taking an active role in decision-making.
For more information, see the Cochrane Collaboration systematic review of patient decision aids for treatment or screening decisions.
When to use a decision aid
Decisions aids are most likely to be used when:
- different treatment options are difficult to compare - for example, when they have very different outcomes, risks or types of complication
- there are trade-offs - for example between short term and long term outcomes
- there is a small risk of a very bad outcome
- for that individual, all available options are very similar in terms of outcomes, benefits and risks
- the patient's overriding priority is to achieve a particular outcome or to avoid a particular risk.
Picker Institute Europe's work on decision support aids
Treatment for abdominal aortic aneurysm: making a choice
Picker Institute Europe worked with the Vascular Research Group at Imperial College London, to examine whether patients with an abdominal aortic aneurysm have any preference between the two main treatment options - endovascular repair or open surgical repair - and to explore the factors which influence the decision-making process and their choice. The project included the development and testing of an information resource for patients.
Urology decision support aid pilot
In 2005, Picker Institute Europe contributed to a decision aid pilot programme involving patients with a diagnosis of early-stage localised prostate cancer or benign prostatic hyperplasia (BPH). The programme aimed to provide patients with tailored, unbiased information about the benefits and possible risks of alternative treatments, and to engage patients in the decision-making process. It was designed to dovetail with the clinical process of care and the treatment decision-making pathway.
The programme took place at four NHS Hospital Trusts across England, and included three elements:
- nurse training
- a video/DVD decision support aid
- a decision quality assessment form.
Picker Institute Europe evaluated the decision aid element of the pilot programme, and published a report 
Implementing Patient Decision Aids in Urology. (2006) describing the findings.
Decision support aids online
The University of Ottawa's Health Research Institute has produced a decision aid Development Toolkit and compiled a database of generic and condition-specific decision aids. Visit the OHRI website.
The International Patient Decision Aid Standards Collaboration is an international group developing quality criteria for patient decision aids. Visit the IPDAS website.
The Foundation for Informed Medical Decision Making develops decision aids for patients and carries out research into how to improve decision quality in healthcare. Visit the Foundation's website.
