--- title: "Shared decision making in clinical medicine: past & future. | Sutter Health" description: "This paper reviews the literature on shared medical decision making. Several questions are considered. Although several studies suggest that patients do not want to be involved in decision making, these studies typically fail to separate decisions about technical aspects of treatment from preferences for outcomes." url: "https://www.sutterhealth.org/research/publications/shared-decision-making-in-clinical-medicine-1055312527" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Shared decision making in clinical medicine: past & future. # Shared decision making in clinical medicine: past research and future directions. Frosch DL & Kaplan RM. _Am J Prev Med. 17(4):285-94._ 1999-11-01 ## Abstract CONTENT: Shared medical decision making is a process by which patients and providers consider outcome probabilities and patient preferences and reach a health care decision based on mutual agreement. Shared decision making is best used for problems involving medical uncertainty. During the process the provider-patient dyad considers treatment options and consequences and explores the fit of expected benefits and consequences of treatment with patient preferences for various outcomes. This paper reviews the literature on shared medical decision making. Several questions are considered. Although several studies suggest that patients do not want to be involved in decision making, these studies typically fail to separate decisions about technical aspects of treatment from preferences for outcomes. There is considerable evidence that patients want to be consulted about the impact of treatment. Studies on the acceptability of shared decision making for physicians have produced inconsistent results. Shared decision making is more acceptable to younger and better-educated patients. It remains unclear whether shared decision making requires expensive video presentations or whether the same results can be obtained with simpler methods, such as the decision board. We conclude that shared medical decision making is an important development in health care. More research is necessary to identify the effects of shared decision making on patient satisfaction and health outcomes. Further, more research is necessary in order to evaluate the most effective methods for engaging patients in decisions about their own health care. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/10606197) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Implementation of patient decision support interventions in primary care: the role of relational coordination.](https://www.sutterhealth.org/research/publications/pt-decision-spt-primary-care-relational-coord-1055312888) Tietbohl CK, Rendle KA, Halley MC, May SG, Lin GA, Frosch DL. Med Decis Making. 35(8):987-98. doi: 10.1177/0272989X15602886. Epub 2015 Aug 27. 2015 Nov 01 - Publication ### [Patient and family engagement: a survey of US hospital practices.](https://www.sutterhealth.org/research/publications/pt-family-engagement-survey-us-hosp-practices-1055312463) Herrin J, Harris KG, Kenward K, Hines S, Joshi MS, Frosch DL. BMJ Qual Saf. pii: bmjqs-2015-004006. doi: 10.1136/bmjqs-2015-004006. \[Epub ahead of print\] 2015 Jun 16 - Publication ### [Communicating with physicians about medical decisions: a reluctance to disagree.](https://www.sutterhealth.org/research/publications/comm-with-mds-re-med-decs-reluctant-to-disagree-1055312531) Adams JR, Elwyn G, Légaré F, Frosch DL. Arch Intern Med. 2012 Aug 13;172(15):1184-6. doi: 10.1001/archinternmed.2012.2360. 2012 Aug 13 - Publication ### [An exploratory mixed-methods crossover study comparing DVD- vs. Web-based patient decision support in three conditions: The importance of patient perspectives.](https://www.sutterhealth.org/research/publications/dvd-vs-web-based-pt-decision-spt-1055312529) Halley MC, Rendle KA, Gillespie KA, Stanley KM, Frosch DL. Health Expect. 18(6):2880-91. doi: 10.1111/hex.12273. Epub 2014 Sep 29. 2015 Dec 01 - Publication ### [Authoritarian physicians and patients' fear of being labeled 'difficult' among key obstacles to shared decision making.](https://www.sutterhealth.org/research/publications/pts-fear-label-difficult-obstacle-shared-decmaking-1055312526) Frosch DL, May SG, Rendle KA, Tietbohl C, Elwyn G. Health Aff (Millwood). 31(5):1030-8. doi: 10.1377/hlthaff.2011.0576. 2012 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/shared-decision-making-in-clinical-medicine-1055312527#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Shared decision making in clinical medicine: past & future."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/shared-decision-making-in-clinical-medicine-1055312527#medicalscholarlyarticle","name":"Shared decision making in clinical medicine: past research and future directions.","headline":"Shared decision making in clinical medicine: past & future.","abstract":"CONTENT: Shared medical decision making is a process by which patients and providers consider outcome probabilities and patient preferences and reach a health care decision based on mutual agreement. Shared decision making is best used for problems involving medical uncertainty. During the process the provider-patient dyad considers treatment options and consequences and explores the fit of expected benefits and consequences of treatment with patient preferences for various outcomes. This paper reviews the literature on shared medical decision making. Several questions are considered. Although several studies suggest that patients do not want to be involved in decision making, these studies typically fail to separate decisions about technical aspects of treatment from preferences for outcomes. There is considerable evidence that patients want to be consulted about the impact of treatment. Studies on the acceptability of shared decision making for physicians have produced inconsistent results. Shared decision making is more acceptable to younger and better-educated patients. 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