<i>Annals</i> Clinical Decision Making: Communicating Risk and Engaging Patients in Shared Decision Making
Authors: Katrina A. Armstrong, Joshua P. Metlay
Journal: Annals of Internal Medicine (2020)

Special Articles19 May 2020Annals Clinical Decision Making: Communicating Risk and Engaging Patients in Shared Decision MakingKatrina A. Armstrong, MD, MS and Joshua P. Metlay, MD, PhDKatrina A. Armstrong, MD, MSMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.) and Joshua P. Metlay, MD, PhDMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3495 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Making good clinical decisions involves understanding evidence, thoughtful application of diagnostic testing, navigating heuristics and biases, and translating population-based evidence to an individual patient. In the end, however, there is often no perfect choice. Most decisions involve meaningful tradeoffs. Nearly all decisions involve significant uncertainty. This reality drives the modern emphasis on involving patients in the decision-making process—a paradigm referred to as "shared decision making." Few argue with the principle that patients should be informed participants in their clinical decisions. Yet, this principle is hard to implement effectively in clinical practice because of challenges inherent to risk communication, preference assessment, ...References1. Metlay JP, Armstrong KA. Annals clinical decision making: Weighing evidence to inform clinicaldecisions. Ann Intern Med. 21 April 2020. [Epub ahead of print]. doi:10.7326/M19-1941 LinkGoogle Scholar2. Armstrong KA, Metlay JP. Annals clinical decision making: Translating population evidence to individual patients. Ann Intern Med. 21 April 2020. [Epub ahead of print]. doi:10.7326/M19-3496 LinkGoogle Scholar3. Whitney SN, McGuire AL, McCullough LB. A typology of shared decision making, informed consent, and simple consent. 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Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014:CD001431. [PMID: 24470076] doi:10.1002/14651858.CD001431.pub4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (K.A.A., J.P.M.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3495.Corresponding Author: Katrina A. Armstrong, MD, Massachusetts General Hospital, Gray-Bigelow 7, 55 Fruit Street, Boston, MA 02114; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Armstrong: Massachusetts General Hospital, Gray-Bigelow 7, 55 Fruit Street, Boston, MA 02114.Dr. Metlay: Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114.Author Contributions: Conception and design: K.A. Armstrong, J.P. Metlay.Drafting of the article: K.A Armstrong, J.P. Metlay.Critical revision for important intellectual content K.A. Armstrong.Final approval of the article: K.A. Armstrong, J.P. Metlay.Administrative, technical, or logistic support: K.A. Armstrong.This article was published at Annals.org on 21 April 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Decision Making: Nurturing Our Core Skills Darren B. Taichman , Sankey V. Williams , and Christine Laine Annals Clinical Decision Making: Weighing Evidence to Inform Clinical Decisions Joshua P. Metlay and Katrina A. Armstrong Annals Clinical Decision Making: Translating Population Evidence to Individual Patients Katrina A. Armstrong and Joshua P. Metlay Clinical Decision Making: Nurturing Our Core Skills Darren B. Taichman , Sankey V. Williams , and Christine Laine Annals Clinical Decision Making: Avoiding Cognitive Errors in Clinical Decision Making Daniel Restrepo , Katrina A. 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Armstrong, MD, MS and Joshua P. Metlay, MD, PhDAnnals Clinical Decision Making: Translating Population Evidence to Individual PatientsKatrina A. Armstrong, MD, MS and Joshua P. Metlay, MD, PhDClinical Decision Making: Nurturing Our Core SkillsDarren B. Taichman, MD, PhD, Executive Editor, Sankey V. Williams, MD, Deputy Editor, and Christine Laine, MD, MPH, Editor in Chief Using the Causal Inference Framework to Support Individualized Drug Treatment Decisions Based on Observational Healthcare Data 19 May 2020Volume 172, Issue 10Page: 688-692KeywordsAlcoholsBreast cancerCancer risk factorsDecision makingExerciseHospital medicineHysterectomyRelative riskSurgeryThromboembolism ePublished: 21 April 2020 Issue Published: 19 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...