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Decision boxes for clinicians to support evidence-based practice and shared decision making: the user experience.
Anik Giguere1, France Légaré, Roland Grad
1Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, CRL-139 1280 Main Street, West Hamilton, ON L8S 4 K1, Canada. anikgiguere@videotron.ca
Implementation Science : IS
|August 7, 2012
Summary
Decision Boxes provide concise summaries for complex medical decisions, aiding shared decision-making between patients and physicians. User feedback led to improved design for better communication of risks and benefits.
Area of Science:
- Health communication
- Shared decision-making
- Patient engagement
Background:
- Decision Boxes are short clinical topic summaries designed to aid communication for medical questions without a single best answer.
- The goal is to prepare clinicians to discuss risks and benefits, enabling informed patient decisions.
Purpose of the Study:
- To develop and refine Decision Boxes through patient and physician engagement.
- To improve the communication design of clinical decision support tools.
Main Methods:
- Selected 10 primary care topics via Delphi survey.
- Developed two prototypes (prostate cancer screening, trisomy 21 screening) and gathered feedback from 15 physicians and 33 patients in focus groups.
- Used User Experience Honeycomb and thematic analysis to identify communication barriers and facilitators, modifying prototypes accordingly.
Main Results:
- Ten clinical topics were selected after three researcher rounds.
- Focus groups with physicians and patients informed revisions, adding sections like "introduction" and "patient counseling."
- Prototypes were reformatted to two pages, enhanced with credibility markers, purpose statements, flowcharts, and risk-stratified benefit/risk information.
Conclusions:
- Findings will guide the development of remaining Decision Boxes.
- Future research will assess the impact of Decision Boxes on evidence-based practice and shared decision-making.
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