title: What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders.
abstract: Informed and shared decision making are critical aspects of patient-centered care, which has contributed to an emphasis on decision support interventions to promote good medical decision making. However, researchers and healthcare providers have not reached a consensus on what defines a good decision, nor how to evaluate it. This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods. This paper also proposes specific research questions within each of these priority areas, with the goal of moving medical decision making research to a more comprehensive definition of a good medical decision, and enhancing the ability to measure and improve the decision making process.
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Jada G
authors: JG
authors: Hamilton
authors: Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors: Sarah E
authors: SE
authors: Lillie
authors: Shidler College of Business, University of Hawaii, Honolulu, HI, USA.
authors: Dana L
authors: DL
authors: Alden
authors: Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.
authors: Laura
authors: L
authors: Scherer
authors: Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: Megan
authors: M
authors: Oser
authors: Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA.|UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
authors: Christine
authors: C
authors: Rini
authors: Health Services Research and Development Service, Department of Veterans Affairs, Washington, DC, USA.
authors: Miho
authors: M
authors: Tanaka
authors: Hawaii Medical Service Association, BCBS of Hawaii, Honolulu, HI, USA.
authors: John
authors: J
authors: Baleix
authors: , St. Louis, MO, USA.
authors: Mikki
authors: M
authors: Brewster
authors: Department of Clinical Sciences and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors: Simon
authors: S
authors: Craddock Lee
authors: Geriatric Research Education and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.|Department of Medicine, Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA.
authors: Mary K
authors: MK
authors: Goldstein
authors: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Robert M
authors: RM
authors: Jacobson
authors: Department of Medical Oncology, Sidney Kimmel Medical Center, Thomas Jefferson University, Philadelphia, PA, USA.
authors: Ronald E
authors: RE
authors: Myers
authors: Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.|Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors: Brian J
authors: BJ
authors: Zikmund-Fisher
authors: Division of Public Health Sciences, Department of Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA. waterse@wudosis.wustl.edu.
authors: Erika A
authors: http://orcid.org/0000-0001-7402-0133
authors: EA
authors: Waters
mesh_terms: D032921:Consensus; D003657:Decision Making; D017408:Guidelines as Topic; D006282:Health Personnel; D006801:Humans; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration*
keywords: Decision making; Decision quality; Patient participation; Patient-centered care; Physician–patient communication; Shared decision making