Prevention & care

Shared decision making: evidence, personal priorities and what decision aids can do

6 sources · Latest source check 2026-10-13 UTC

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Shared decision making combines discussion of healthcare options with what matters to the patient. A clinician brings relevant clinical information, while the person describes priorities and practical circumstances. A decision aid can support that conversation; it does not make the patient’s choice automatically.[1]

Different supports answer different needs

Different supports answer different needs
Category	Meaning	Boundary
Shared discussion	Exchange of options, evidence and priorities	Can need more than one visit[2]
Patient decision aid	Structured help comparing options and thinking about values	Does not replace clinical interpretation[2]
Decision coaching	Additional support to work through the decision	Added benefit over an aid alone remains uncertain[6]
Evidence-quality criteria	Expectations for current, critically appraised information	A polished interface is not enough[3]

The elements can be revisited

AHRQ’s SHARE conversation guide includes seeking participation, comparing options, assessing values, reaching a decision and evaluating it. The elements can be used in different orders and repeated. It prompts clinicians to check understanding and discuss whether practical barriers may prevent following the chosen plan. That is different from asking someone to select from a menu without an explanation. An aid or a worksheet is useful only in the context of the actual options and a conversation about what matters.[2]

A preference is relevant information

AHRQ’s model describes dialogue about benefits, harms, risks and patient priorities. People can value outcomes differently, or face different constraints on implementing a plan. Clarifying these differences helps identify questions needing attention; it does not make every requested intervention clinically suitable. A clinician’s recommendation and a patient’s values can both be discussed. The model is professional communication guidance, rather than proof that a particular choice is medically optimal or that the patient must decide without support.[1]

Check what supports the comparison

The 2021 IPDAS evidence update says high-quality patient decision aids should be grounded in comprehensive, current syntheses of critically appraised evidence. Ask which decision the tool addresses, which options it includes, where estimates come from and when the evidence was updated. This standard does not mean every tool carrying a decision-aid label meets it. The update was inspected through original indexed excerpts, not an independent full-text appraisal. An appealing presentation and a transparent evidence basis are separate qualities.[3]

Evidence & uncertainty

A 2024 Cochrane review found improvements in knowledge, risk perception and participation across many treatment and screening decisions. Its evidence concerns tested decision-support tools and outcomes, rather than proving that any webpage or questionnaire produces the same benefit.[4]

Selected-source overview · Independent review pending

Published questions

Will a patient decision aid tell me the single right treatment?

Selected-source overview · Independent review pending. Read the evidence context.

It supports comparison and reflection on priorities, alongside discussion with the clinician. AHRQ frames this as choosing together, including checking understanding and what may get in the way. It does not automate the choice.[2]

Evidence behind this answer

The SHARE Approach: Conversation Starters
agency explanation · 2024
Selected relevant original official passages or original methods/results inspected; no independent full-document appraisal · Five flexible/repeated elements; support, understanding and implementation