Shared Decision-making in Urology: The SHINE-URO Consensus Framework

Shared decision-making (SDM) is recognised as a cornerstone of patient-centred care, yet progress in embedding SDM in urology has been inconsistent. The European Association of Urology (EAU) Patient Office convened urologists, nurses, and patient advocates at two consensus meetings (Paris, France, March 2024; Rome, Italy, November 2024) to define core SDM principles and identify barriers to implementation. The outcome was the SHINE-URO framework, comprising six principles: open discussion of harms and benefits; exploration of patient values and goals; provision of clear and guideline-based information; creation of safe environments for sensitive topics; addressing misinformation and patient skills; and offering information before consultations. Key barriers to implementation included time constraints; accessibility and inclusion challenges; professional role concerns; underuse of "no treatment" as an option; and insufficient involvement of family members and caregivers. This multidisciplinary collaboration has delivered a consensus definition of SDM in urology and a roadmap for its implementation. Adoption of SHINE-URO in clinical practice requires system-level support, resources, and training to ensure equitable, patient-centred care. PATIENT SUMMARY: We developed a new framework for shared decision-making in urology called SHINE-URO. This framework focuses on clear information, patient values, and preparation before consultations. This will help patients in making informed choices about their care together with their doctors.