Evidence map›Paper›PMID 31682503›Full record

ArticleHealth affairs (Project Hope)2019

Potential Unintended Consequences Of Recent Shared Decision Making Policy Initiatives.

Jennifer Blumenthal-Barby, Douglas J Opel, Neal W Dickert, Daniel B Kramer, Brownsyne Tucker Edmonds, Keren Ladin, Monica E Peek, Jeff Peppercorn, Jon Tilburt

Abstract read
In one paragraph

Article in Health affairs (Project Hope), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Cultural impacts on shared decision-making: A cross-European study of psychiatrist preferences in 38 countries.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Article
  4. Shared Decision-Making and Discontinuation of Opioid Therapy for Chronic Pain.Journal of the American Board of Family Medicine : JABFM · 2025
    Article
  5. Article
  6. Risk management during times of health uncertainty in Spain: A qualitative analysis of ethical challenges.Risk analysis : an official publication of the Society for Risk Analysis · 2025
    Article
  7. Legal and Ethical Issues in Periviable Decision-Making in the Current Moment.The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics · 2025
    Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Observational
  15. Article
  16. Article
  17. Effect of a Prostate Cancer Screening Decision Aid for African-American Men in Primary Care Settings.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020
    Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Jennifer Blumenthal-BarbyJennifer Blumenthal-Barby ( jsswinde@bcm. edu ) is the Cullen Associate Professor and associate director of the Center for Medical Ethics and Health Policy, Baylor College of Medicine, in Houston, Texas.
Douglas J OpelDouglas J. Opel is an associate professor of pediatrics at the University of Washington School of Medicine and director of clinical ethics at the Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, in Washington.
Neal W DickertNeal W. Dickert is an associate professor of cardiology and epidemiology at Emory University, in Atlanta, Georgia.
Daniel B KramerDaniel B. Kramer is an assistant professor at Harvard Medical School and faculty at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, both in Boston, Massachusetts.
Brownsyne Tucker EdmondsBrownsyne Tucker Edmonds is an associate professor of obstetrics and gynecology and assistant dean for diversity affairs at the Indiana University School of Medicine, in Indianapolis.
Keren LadinKeren Ladin is an assistant professor of occupational therapy and community health at Tufts University, in Medford, Massachusetts.
Monica E PeekMonica E. Peek is an associate professor of medicine at the University of Chicago Medical Center, in Illinois.
Jeff PeppercornJeff Peppercorn is an associate professor in and director of the Cancer Survivorship Program, Cancer Center, Massachusetts General Hospital, in Boston.
Jon TilburtJon Tilburt is a professor of internal medicine and biomedical ethics at Mayo Clinic in Rochester, Minnesota.

Funding

Research Design, Data, and Analytics CoreP30DK092949 · NIDDK · UNIVERSITY OF CHICAGO · PI MARSHALL H CHIN · 2011 to 2026
$10.0M
NIDDK NIH HHS P30 DK092949
6 · The paper itself

Abstract

Shared decision making (SDM)-when clinicians and patients make medical decisions together-is moving swiftly from an ethical ideal toward widespread clinical implementation affecting millions of patients through recent policy initiatives. We argue that policy initiatives to promote SDM implementation in clinical practice carry the risk of several unintended negative consequences if limitations in defining and measuring SDM are not addressed. We urge policy makers to include prespecified definitions of desired outcomes, offer guidance on the tools used to measure SDM in the multitude of contexts in which it occurs, evaluate the impact of SDM policy initiatives over time, review that impact at regular intervals, and revise SDM measurement tools as needed.

Indexed as

Decision Making, SharedDelivery of Health CareOrganizational PolicyPatient ParticipationHumansCancer patientsethicsHealth policyMedical researchpatient engagementpublic healthQuality of careShared decision making

Identifiers

PMID31682503
PMCPMC7087349

What OpenQuestion holds

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Registered trials

None linked

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.