Step 2: Find Patient Decision Aid(s)
Search for and review decision aids to find those of higher quality and applicable.

Is there a decision aid(s) focused on the decision? What is the quality of the decision aid(s) using the International Patient Decision Aids Standards (IPDAS) checklist? Is the decision aid applicable to the situation and setting? Based on its quality and relevance, which decision aid fits best? If no decision aids are available, can the generic Ottawa Personal/Family Decision Guide be used?

2.1 Go to the A to Z Inventory of Decision Aids

1. Is there a decision aid(s) about the decision?
   Patient decision aids, such as pamphlets, videos, and/or interactive online programs are designed to help people understand the options (including pros/cons, benefits/harms), consider the personal importance of possible benefits and harms, and participate in decision making.
2. What is the quality of the decision aid(s) using the International Patient Decision Aids Standards (IPDAS) checklist?
3. Is the decision aid applicable to the situation and setting?
   Decision aids are developed in Canada, the United States, England, Australia and a few other countries. For this reason, the information on options may not fit all health situations and/or settings.
4. Based on its quality and relevance, which decision aid fits best with the target population?
   Select one or more decision aids.

2.2 Try the Ottawa Personal Decision Guide (OPDG)

If no decision aids are available, can one of the versions of the Ottawa Personal Decision Guide be used?

They are worksheets to help people making any health or social decision. They guide people to clarify the decision, explore the decision, identify decision making needs, and plan the next steps. These guides are also used by health professionals to coach patients making decisions.

2.3 Going beyond the A to Z Inventory to find and appraise decision aids

1. Decision Aid Library Inventory (DALI)
   To find out if there are decision aids in development, being evaluated or no longer publicly available, check the Complete Inventory of DALI. It lists all of the decisions aids in the DALI along with developer contact information.
2. IPDASi Instrument
   The IPDAS Instrument (IPDASi) was developed to conduct a more thorough appraisal of the quality of patient decision aids. Rather than indicating if the IPDAS criterion is met or not met, each criterion is rated on a 4-point scale from strongly agree to strongly disagree.
3. Acceptability of the decision aid
   A measurement tool is available to determine the acceptability of the decision aid. It can be completed by patients and/or healthcare professionals when they review the decision aid.
4. Assessing the fit of the decision aid
   Questions about the fit of the decision aid can be asked at the same time as a more formal assessment of factors likely to influence their use (see Step 3).

Examples of additional resources

Barry MJ, Fowler FJ Jr, Mulley AG Jr, Henderson JV Jr, Wennberg JE. (1995). Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care; Aug;33(8):771-82.

Elwyn G, O'Connor A, Stacey D, Volk R, Edwards A, Coulter A, Thomson R, Barratt A, Barry M, Bernstein S, Butow P, Clarke A, Entwistle V, Feldman-Stewart D, Holmes-Rovner M, Llewellyn-Thomas H, Moumjid N, Mulley A, Ruland C, Sepucha K, Sykes A, Whelan T; International Patient Decision Aids Standards (IPDAS) Collaboration. (2006). Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ; 333(7565):417-422.

Elwyn G, O'Connor AM, Bennett C, Newcombe RG, Politi M, Durand MA, Drake E, Joseph-Williams N, Khangura S, Saarimaki A, Sivell S, Stiel M, Bernstein SJ, Col N, Coulter A, Eden K, Härter M, Rovner MH, Moumjid N, Stacey D, Thomson R, Whelan T, van der Weijden T, Edwards A. (2009). Assessing the quality of decision support technologies using the International Patient Decision Aids Standards instrument (IPDASi). PLoS One; 4(3):1-9.