Challenges for designing and implementing decision aids

Decision aids are tools intended to help patients with decisions about their health-care. We have developed three decision aids to help patients with treatment decisions for: locally advanced non-small cell lung cancer (LA-NSCLC), advanced non-small cell lung cancer (A-NSCLC), and early-stage prostate cancer (ES-PC). In developing the aids, we carried out studies to provide them with an empirical basis, and to evaluate their potential for impact. In this paper we report results that challenge common assumptions and typical practice that currently occurs in the development of decision aids. The challenges relate to: how the content of the aid is defined, how the information is presented, how to incorporate decision aids into the dynamic, complex process of making such decisions, and how to evaluate the aids. We conclude that critical appraisal of issues related to the design and implementation of decision aids is required.