Sometimes it can be hard to make a health decision when there are a lot of different options and possible outcomes.  Decision aids are tools that help people who need to make a decision.  They help by:

• clearly identifying what decision needs to be made,
• helping people work through the options and possible outcomes, and
• helping people to clarify their priorities and values.

They are meant to help you discuss your options with health professionals, not to replace those discussions.

Decision aids can be pamphlets, videos, or web-based tools.

Using a decision aid can be particularly helpful when:

• there is more than one reasonable option,
• there is not one option that is clearly best for your health outcomes, or
• each option has benefits and harms that are more or less important to you than to other people.

Why use a decision support tool?

There is good evidence[1] that using decision support tools, such as a decision aid, can help consumers by:

• Improving your knowledge of the options,
• Helping clarify what matters most to you,
• Setting realistic expectations about the possible benefits and harms of different options,
• Giving you confidence to talk about your preferences, and
• Helping you to participate more in shared decision making.

Decision aids are most helpful for complex decisions that need careful consideration. They can help you work out what importance you place on possible outcomes, how different options could impact on your personal circumstances, and how your values might affect your decision.

ReachOut has some simple tips on making decisions.

Some decision aids

The Ottawa Health Research Institute in Canada has developed a Personal Decision Guide for people making health or personal decisions [PDF].  You can use this tool to work through any major decision.

Visit the Ottawa Health Research Institute website to find their guide in other languages, as well as a “family guide”.

The BRAIN Informed Decision Making tool is a simple tool to help you work your way through a difficult decision.  It can help you collect information and clarify your thoughts about an important decision.

Decision aids for specific health conditions

Decision aids for specific medical conditions bring together evidence about conditions and treatments to help consumers compare the risks and benefits of different treatment options and to help work out what is the best option for the individual.

The Australian Commission on Safety and Quality in Health Care has developed some decision support tools for consumers with specific conditions. They currently have tools to help you make decisions about antibiotics for you or your child, and about osteoarthritis of the knee. You can find the resources on their website: Decision support tools for specific conditions.

The Royal Australian College of General Practitioners (RACGP) has developed some tools to help you make a decision about using certain screening tests or treatments when the risks might outweigh the benefits: First do no harm – Patient resources.

The Ottawa Health Research Institute has compiled a list of decision aids for specific conditions that comply with international standards for decision aids.  They have an alphabetical listing that you can search.

Dartmouth-Hitchcock medical service in the US has a user-friendly online health information and decision aid – Healthwise Health Encyclopedia.  It is US based, but has good information on specific diseases, tests and points in health care when you need to make decisions.

Dig Deeper

A good decision aid should:

• Be evidence-based, and use evidence-based statements of benefits and risks from credible sources,
• Be balanced in presenting all options (including doing nothing),
• Clearly set out the benefits and risks of all the options,
• Be up-to-date and include current evidence and treatment options, and
• Clearly say who produced the aid and any conflicts of interests, like being funded by pharmaceutical companies.

The International Patient Decision Aid Standards (IPDAS) Collaboration is a group of researchers, health professionals and stakeholders from around the world. They work to improve the quality and effectiveness of patient decision aids.  Thier evidence-based framework that has a set of criteria for improving the content, development, implementation, and evaluation of decision aids for specific conditions and treatments.

The article Helping Patients Make Better Treatment Choices with Decision Aids from the Commonwealth Fund discusses why health professionals should be using decision aids to encourage shared decision making.

Cochrane has made a summary of the evidence for using decision aids to make more informed decisions.

References:

[1] Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub5