title: A systematic review of shared decision making interventions in chronic conditions: a review protocol.
abstract: BACKGROUND
  Chronic conditions are a major source of morbidity, mortality and cost worldwide. Shared decision making is one way to improve care for patients with chronic conditions. Although it has been widely studied, the effect of shared decision making in the context of chronic conditions is unknown.
  
  
  METHODS
  We will perform a systematic review with the objective of determining the effectiveness of shared decision making interventions for persons diagnosed with chronic conditions. We will search the following databases for relevant articles: PubMed, Scopus, Ovid MEDLINE, Ovid EMBASE, Ovid EBM Reviews CENTRAL, CINAHL, and Ovid PsycInfo. We will also search clinical trial registries and contact experts in the field to identify additional studies. We will include randomized controlled trials studying shared decision making interventions in patients with chronic conditions who are facing an actual decision. Shared decision making interventions will be defined as any intervention aiming to facilitate or improve patient and/or clinician engagement in a decision making process. We will describe all studies and assess their quality. After adjusting for missing data, we will analyze the effect of shared decision making interventions on outcomes in chronic conditions overall and stratified by condition. We will evaluate outcomes according to an importance ranking informed by a variety of stakeholders. We will perform several exploratory analyses including the effect of author contact on the estimates of effect.
  
  
  CONCLUSIONS
  We anticipate that this systematic review may have some limitations such as heterogeneity and imprecision; however, the results will contribute to improving the quality of care for individuals with chronic conditions and facilitate a process that allows decision making that is most consistent with their own values and preferences.
  
  
  BACKGROUND
  PROSPERO Registration Number: CRD42013005784.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Gionfriddo
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Leppin
authors.forename: Juan P
authors.initials: JP
authors.lastname: Brito
authors.forename: Annie
authors.initials: A
authors.lastname: Leblanc
authors.forename: Kasey R
authors.initials: KR
authors.lastname: Boehmer
authors.forename: Megan A
authors.initials: MA
authors.lastname: Morris
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Prokop
authors.forename: Claudia L
authors.initials: CL
authors.lastname: Zeballos-Palacios
authors.forename: German
authors.initials: G
authors.lastname: Malaga
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
authors.forename: Heidi M
authors.initials: HM
authors.lastname: McLeod
authors.forename: René
authors.initials: R
authors.lastname: Rodríguez-Gutiérrez
authors.forename: Rongchong
authors.initials: R
authors.lastname: Huang
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Morey-Vargas
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. montori.victor@mayo.edu.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003657:Decision Making; D006801:Humans; D010358:Patient Participation; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome
references.citation: BMC Med Inform Decis Mak. 2013;13 Suppl 2:S12
references.pmid: 24625035
references.citation: Prev Chronic Dis. 2011 Jan;8(1):A09
references.pmid: 21159221
references.citation: Health Aff (Millwood). 2013 Feb;32(2):223-31
references.pmid: 23381514
references.citation: Z Evid Fortbild Qual Gesundhwes. 2011;105(4):313-24
references.pmid: 21620327
references.citation: J Gen Intern Med. 2006 Apr;21(4):360-2
references.pmid: 16686813
references.citation: Cochrane Database Syst Rev. 2014 Jan 28;(1):CD001431
references.pmid: 24470076
references.citation: BMJ. 1997 Sep 13;315(7109):629-34
references.pmid: 9310563
references.citation: Health Aff (Millwood). 2009 Jan-Feb;28(1):64-74
references.pmid: 19124856
references.citation: Fam Pract. 2004 Aug;21(4):337-46
references.pmid: 15249520
references.citation: PLoS One. 2013;8(2):e57132
references.pmid: 23451162
references.citation: Patient Educ Couns. 2012 Aug;88(2):159-69
references.pmid: 22305195
references.citation: Med Care. 2003 May;41(5):582-92
references.pmid: 12719681
references.citation: BMJ Qual Saf. 2012 Jun;21(6):519-23
references.pmid: 22447817
references.citation: Control Clin Trials. 1986 Sep;7(3):177-88
references.pmid: 3802833
references.citation: Patient Educ Couns. 2006 Mar;60(3):301-12
references.pmid: 16051459
references.citation: J Clin Epidemiol. 2013 Sep;66(9):1014-1021.e1
references.pmid: 23774111
references.citation: Z Evid Fortbild Qual Gesundhwes. 2011;105(4):305-12
references.pmid: 21620326
references.citation: Psychother Psychosom. 2008;77(4):219-26
references.pmid: 18418028
references.citation: Patient. 2012;5(1):1-19
references.pmid: 22276987
references.citation: Health Expect. 2006 Mar;9(1):25-36
references.pmid: 16436159
references.citation: Z Evid Fortbild Qual Gesundhwes. 2011;105(4):229-33
references.pmid: 21620313
references.citation: J Clin Epidemiol. 2009 Oct;62(10):1006-12
references.pmid: 19631508
references.citation: JAMA. 1988 Sep 23-30;260(12):1743-8
references.pmid: 3045356
references.citation: J Clin Epidemiol. 2011 Apr;64(4):383-94
references.pmid: 21195583
references.citation: Cochrane Database Syst Rev. 2012 Dec 12;12:CD003267
references.pmid: 23235595
references.citation: BMJ. 2003 Sep 6;327(7414):557-60
references.pmid: 12958120