Many health treatment and screening decisions have no single ’best’ choice. These types of decisions are considered ’preference sensitive’ because there is insufficient evidence about outcomes or there is a need to trade off known benefits and harms. Clinical Evidence analyzed 3000 treatments, classifying 50% as having insufficient evidence, 24% as likely to be beneficial, 7% as requiring trade-offs between benefits and harms, 5% as unlikely to be beneficial, 3% as likely to be ineffective or harmful, and only 11% as being clearly beneficial. Not only does one have to take into account the strength of the evidence, but even for the 11% of treatments that show beneficial effects for populations, physicians need to translate the probabilistic nature of the evidence for individual patients to help them reach a decision based on informed values. Patient decision aids are an intervention that can be used to present such evidence.

Key findings

- People who use decision aids may achieve decisions that are consistent with their informed values (evidence is not as strong; more research could change results).

- People and their clinicians were more likely to talk about the decision when using a decision aid.

- Decision aids have a variable effect on the option chosen, depending on the choice being considered.

- Decision aids do not worsen health outcomes, and people using them are not less satisfied.