Assignment: Value-based Decisions

Assignment: Value-based Decisions
Assignment: Value-based Decisions
Studies to date have demonstrated
that while decision aids enhance knowledge,
reduce decisional conflict, increase involvement
in the decision-making process and lead to
informed value-based decisions, their impact on
the quality of the decision, satisfaction with the
decision making process and health outcomes
remains unclear.11
Besides enabling patients to make informed
choices, decision aids also have the potential to
facilitate SDM by improving the quality and
efficiency of the patient–provider encounter.
Relatively few studies have examined the utility
of decision aids for promoting effective SDM
from the perspective of the provider. Studies to
date have largely focused on provider perspec-
tives on the quality of the decision tools
themselves or issues related to implementation
into clinical practice.11–15 The overall objective
of this study was to elicit provider feedback
regarding the extent to which the use of a novel
colorectal cancer (CRC) screening decision aid
facilitated SDM in the primary care setting
within the context of a randomized clinical
Brief overview of decision aid and randomized
clinical trial
Details of the decision aid, recruitment process,
study design and secondary outcome results
have been previously published.16 The overall
objective of the trial was to evaluate the impact
of a novel computer-based decision aid on SDM
and patient adherence to CRC screening rec-
ommendations. The decision aid uses video-
taped narratives and state-of-the-art graphics in
digital video disc (DVD) format to convey key
information about CRC and the importance of
screening, compare each of five recommended
screening options using both attribute- and
option-based approaches, and elicit patient
preferences. A modified version of the tool also
incorporated the web-based �Your Disease Risk (YDR)� CRC risk assessment tool (http:// To assess its
impact on SDM and screening adherence,
average-risk, English-speaking patients 50–
75 years of age due for CRC screening were
randomized to one of the two intervention arms
(decision aid plus the YDR personalized risk
assessment tool with feedback or decision aid
alone) or a control arm, each of which involved
an interactive computer session just prior to a
scheduled visit with their primary care provider
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