ArticleHealth expectations : an international journal of public participation in health care and health policy2006
Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision.
Article in Health expectations : an international journal of public participation in health care and health policy, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03023813 (Individualizing Disease Prevention for Middle-Aged Adults), which is not on this map. Cited by 100 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Individualizing Disease Prevention for Middle-Aged Adults
Who cites it
100 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- To what extent do general practitioners involve patients in decision-making? A systematic review of studies using the OPTION-instrument.Primary health care research & development · 2025Pooled it
- Shared decision-making in type 2 diabetes: a systematic review of patients' preferences and healthcare providers' perspectives.BMC health services research · 2025Pooled it
- A systematic review of shared decision making training programs for general practitioners.BMC medical education · 2024Pooled it
- Measuring shared decision making in oncology: Development and first testing of the iSHAREpatient and iSHAREphysician questionnaires.Health expectations : an international journal of public participation in health care and health policy · 2020Pooled it
- Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.Health expectations : an international journal of public participation in health care and health policy · 2015Pooled it
- Patients' perceptions of sharing in decisions: a systematic review of interventions to enhance shared decision making in routine clinical practice.The patient · 2012Pooled it
- Interventions before consultations to help patients address their information needs by encouraging question asking: systematic review.BMJ (Clinical research ed.) · 2008Pooled it
- Interventions before consultations for helping patients address their information needs.The Cochrane database of systematic reviews · 2007Pooled it
- Trial
- Interactivity in a Decision Aid: Findings From a Decision Aid to Technologically Enhance Shared Decision Making RCT.American journal of preventive medicine · 2019Trial
- The effectiveness of shared decision-making followed by positive reinforcement on physical disability in the long-term follow-up of patients with nonspecific low back pain in primary care: a clustered randomised controlled trial.BMC family practice · 2018Trial
- How Does a Shared Decision-Making (SDM) Intervention for Oncologists Affect Participation Style and Preference Matching in Patients with Breast and Colon Cancer?Journal of cancer education : the official journal of the American Association for Cancer Education · 2018Trial
- Communicating risk using absolute risk reduction or prolongation of life formats: cluster-randomised trial in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Trial
- Impact of DECISION + 2 on patient and physician assessment of shared decision making implementation in the context of antibiotics use for acute respiratory infections.Implementation science : IS · 2013Trial
- Trial
- Patient-physician agreement on the content of CHD prevention discussions.Health expectations : an international journal of public participation in health care and health policy · 2011Trial
- Telling Not Asking: A Framework Method Analysis of Shared Decision-Making in Antenatal Clinic Consultations.Birth (Berkeley, Calif.) · 2026Article
- Lived Experience, Family, and Clinician Perspectives on Barriers to Adult Autism Diagnosis and Post-Diagnostic Supports: A Mixed-Methods Systematic Review.Journal of developmental and physical disabilities · 2026Article
- Improving shared decision-making in bronchiectasis.BMJ open respiratory research · 2025Review
- Pregnant women's eHealth literacy and attitudes toward internet health information and their relationship to shared decision making: a cross-sectional study.Women's health nursing (Seoul, Korea) · 2025Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice.
aimsWe undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely.
methodThe study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi-structured telephone interviews were conducted and analysed using the constant comparative method of content analysis.
resultsAll patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as 'patient-led'. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions.
conclusionsPractitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non-alignment of patient preferences with the actual model of decision making if this occurs.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.