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

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Abstract

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.

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Acknowledgments

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).

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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.

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Hamilton, J.G., Lillie, S.E., Alden, D.L. et al. What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders. J Behav Med 40, 52–68 (2017). https://doi.org/10.1007/s10865-016-9785-z

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