Journal of Behavioral Medicine

, Volume 40, Issue 1, pp 52–68 | Cite as

What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders

  • Jada G. Hamilton
  • Sarah E. Lillie
  • Dana L. Alden
  • Laura Scherer
  • Megan Oser
  • Christine Rini
  • Miho Tanaka
  • John Baleix
  • Mikki Brewster
  • Simon Craddock Lee
  • Mary K. Goldstein
  • Robert M. Jacobson
  • Ronald E. Myers
  • Brian J. Zikmund-Fisher
  • Erika A. Waters


Informed and shared decision making are critical aspects of patient-centered care, which has contributed to an emphasis on decision support interventions to promote good medical decision making. However, researchers and healthcare providers have not reached a consensus on what defines a good decision, nor how to evaluate it. This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods. This paper also proposes specific research questions within each of these priority areas, with the goal of moving medical decision making research to a more comprehensive definition of a good medical decision, and enhancing the ability to measure and improve the decision making process.


Decision making Shared decision making Decision quality Patient-centered care Physician–patient communication Patient participation 



This work was supported by NCI P30 CA008748 (Jada G. Hamilton), the University Cancer Research Fund (UCRF) of the University of North Carolina at Chapel Hill (Christine Rini), AHRQ R24 HS0022418 and CPRIT PP120097; 150053 (Simon Craddock Lee), the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (Robert M. Jacobson), and NCATS UL1TR000448 (Erika A. Waters).

Compliance with ethical standards

Conflict of interest

Jada G. Hamilton, Sarah E. Lillie, Dana L. Alden, Laura Scherer, Megan Oser, Christine Rini, Miho Tanaka, John Baleix, Mikki Brewster, Simon Craddock Lee, Mary K. Goldstein, Robert M. Jacobson, Ronald E. Myers, Brian J. Zikmund-Fisher and Erika A. Waters declare that they have no conflict of interest.

Human and animal rights and Informed consent

This article does not contain any studies with human participants performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

Supplementary material

10865_2016_9785_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jada G. Hamilton
    • 1
  • Sarah E. Lillie
    • 2
  • Dana L. Alden
    • 3
  • Laura Scherer
    • 4
  • Megan Oser
    • 5
  • Christine Rini
    • 6
    • 7
  • Miho Tanaka
    • 8
  • John Baleix
    • 9
  • Mikki Brewster
    • 10
  • Simon Craddock Lee
    • 11
  • Mary K. Goldstein
    • 12
    • 13
  • Robert M. Jacobson
    • 14
  • Ronald E. Myers
    • 15
  • Brian J. Zikmund-Fisher
    • 16
    • 17
  • Erika A. Waters
    • 18
  1. 1.Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Center for Chronic Disease Outcomes ResearchMinneapolis VA Health Care SystemMinneapolisUSA
  3. 3.Shidler College of BusinessUniversity of HawaiiHonoluluUSA
  4. 4.Department of Psychological SciencesUniversity of MissouriColumbiaUSA
  5. 5.Department of Psychiatry, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  6. 6.Department of Health BehaviorUniversity of North CarolinaChapel HillUSA
  7. 7.UNC Lineberger Comprehensive Cancer CenterChapel HillUSA
  8. 8.Health Services Research and Development ServiceDepartment of Veterans AffairsWashingtonUSA
  9. 9.Hawaii Medical Service AssociationBCBS of HawaiiHonoluluUSA
  10. 10.St. LouisUSA
  11. 11.Department of Clinical Sciences and Harold C. Simmons Comprehensive Cancer CenterUniversity of Texas Southwestern Medical CenterDallasUSA
  12. 12.Geriatric Research Education and Clinical Center (GRECC)VA Palo Alto Health Care SystemPalo AltoUSA
  13. 13.Department of Medicine, Center for Primary Care and Outcomes ResearchStanford UniversityStanfordUSA
  14. 14.Department of Pediatric and Adolescent MedicineMayo ClinicRochesterUSA
  15. 15.Department of Medical Oncology, Sidney Kimmel Medical CenterThomas Jefferson UniversityPhiladelphiaUSA
  16. 16.Department of Health Behavior and Health EducationUniversity of MichiganAnn ArborUSA
  17. 17.Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  18. 18.Division of Public Health Sciences, Department of SurgeryWashington UniversitySt. LouisUSA

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