Mission

To explore better ways to help patients make "tough" healthcare decisions that may have:

• multiple options;
• uncertain outcomes;
• benefits and harms that people value differently.

To explore better ways to help practitioners support patients making "tough" healthcare decisions.

Research Objectives

We will conduct systematic investigations to:

• understand the decisional needs of patients, and their practitioners;
• design and evaluate decision aids and coaching interventions;
• design and evaluate strategies for implementing decision support services; and
• develop and evaluate training programs to improve the quality of practitioners’ decision support.

History

Some of the contributions of the Patient Decision Aids Research Group include:

2010
Professor Dawn Stacey becomes director of the Patient Decision Aids Research Group.

2009
Advised on U.S. Federal Legislation on shared decision making.

Developed the iShould application, based on the OPDG, for the users of the Facebook social networking platform.

Developed decision aid for: HPV and cervical cancer

2008
Developed decision aid for: preventing influenza

2007
Advised on U.S. Washington State Legislation on shared decision making.

Developed decision aid for: travel to areas where chloroquine will not prevent malaria

2006
Developed decision aid for: non-steroidal anti-inflammatory drugs (NSAIDs) or cox2 inhibitors (Coxibs) for osteoarthritis

2005
Hosted the International Shared Decision Making Conference.

2004
Co-lead on the International Patient Decision Aids Standards (IPDAS) initiative. More than 100 participants from 14 countries.

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. Developing a quality criteria framework for patient decision aids: an online international Delphi consensus process. British Medical Journal. 2006 Aug 26;333(7565):417.

Published training case studies on the use of patient decision aids.

Tugwell P, O’Connor AM et al. A 64 year old woman with knee pain:
Case presentation. BMJ. 2004;328:1362-3.
Case progression. BMJ. 2004;328:1425.
Case outcome. BMJ. 2004;329:38.

Published medical text containing patient decision aids.

O’Connor AM, et al. Knowledge Translation for Patients: Methods to Support Patients’ Participation in Decision Making About Preference-Sensitive Treatment Options in Rheumatology in P. Tugwell, B. Shea, M. Boers, P. Brooks, L.S. Simon, V. Strand & G. Wells (eds), Evidence-Based Rheumatology. BMJ Books. pp. 41-62. 2004.

Developed decision aids for:

• treating rheumatoid arthritis
• lupus
• vasculitis
• scleroderma and associated raynauds
• gout
• rotator cuff
• tennis elbow
• ankylosing spondylitis

2003
Developed e-tools to capture and monitor changes in decisional needs.

Developed the Decision Support Analysis Tool (DSAT). Provide tailored feedback on decision supporting strategies.

Guimond P, Bunn H, O’Connor AM, Jacobsen MJ, Tait VK, Drake ER, Graham ID, Stacey D, Elmslie T. Validation of a tool to assess health practitioners' decision support and communication skills. Patient Educ Couns. 2003 Jul;50(3):235-45.

Developed the Ottawa Decision Support Tutorial (ODST). Online auto-tutorial training in the skill of decision support as a clinical skill.

Published a national survey of the public's decisional needs regarding medical treatment.

O’Connor AM, Drake ER, Wells GA, Tugwell P, Laupacis A, Elmslie T. A survey of the decision-making needs of Canadians faced with complex health decisions. Health Expect. 2003;6(2):97-109.

Updated and validated the Decision Regret Scale.

Brehaut JC, O’Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, Feldman-Stewart D. Validation of a Decision Regret Scale Med Decis Making. 2003;23(4):281-292.

2002
Developed the Ottawa Personal Decision Guide (OPDG) a generic patient decision aid for assessing and addressing patients’ decisional needs (practitioner-administered and self-administered versions) used in nurse call centres and serving millions.

O’Connor AM, Jacobsen MJ, Stacey D. An evidence-based approach to managing women’s decisional conflict. J Obstet Gynecol Neonatal Nurs. 2002;31(5):570-81.

Developed decision aid for: life changes for lowering risk of heart disease and stroke

2001
Created a global inventory of patient decision aids.

O’Connor AM, Stacey D, Rovner D et al. Decision aids for people facing health treatment or screening decision (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford: Update software.

Contributed chapter in the first book on shared patient decision making.

O’Connor AM, Edwards A. The Role of Decision Aids in Promoting Evidence-Based Patients Choice. In Edwards A, Elwyn G, editors. Evidence-Based Patient Choice. Oxford: Oxford University Press; 2001.

2000
Advised on the rollout of decision support services at Dartmouth Hitchcock Medical Center, UK National Health Service and Australia.

Developed other decision support tools:

• A Guide for People Facing Decisions about Health or Social Situations
• Ottawa Decision Support Guide: Practitioner Worksheet
• An information package and treatment decision aid
• Guide de l’Équipe d’Ottawa pour l’évaluation et la planification des décisions sur le support à la décision
• Weighing My Own Pros and Cons. A Personal Assessment Worksheet

Developed decision aids for:

• hepatitis C
• patient involvement in decisions about breast cancer
• cancer screening program for hereditary susceptibility to breast, ovarian and associated cancers
• location of care for person with dementia
• osteoporosis treatments
• preventing stroke from atrial fibrillation

1999
Lead the first systematic review of randomized trials of patient decision aids published by an international Cochrane Collaboration review team in the British Medical Journal.

O’Connor AM, Rostom A, Fiset V, Tetroe J, Entwistle V, Llewellyn-Thomas H, et al. Decision aids for patients facing health treatment or screening decisions: A Cochrane systematic review. BMJ. 1999;319:731-4.

Published a methods paper on how to develop and evaluate patient decision aids.

O’Connor AM, Fiset V, DeGrasse C, Graham I, Evans W, Stacey D, et al. Decision aids for patients considering health care options: Evidence of efficacy and policy implications. J Natl Cancer Inst Monogr. 1999;25:67-80.

Developed decision aids for:

• prenatal testing
• lowering risk of breast cancer
• cognitively impaired individuals with feeding problems
• blood transfusion for heart surgery
• end-of-life management of advanced stage chronic obstructive pulmonary disease

1998
Developed a conceptual framework (Ottawa Decision Support Framework) for managing patients' decisional needs.

O’Connor AM, Tugwell P, Wells G, et al. A decision aid for women considering hormone therapy after menopause: Decision support framework and evaluation. Patient Educ Couns. 1998;33(3):267-79.

Developed a workbook and measurement tools for surveying decision making needs of populations.

1997
Published a regional survey of physicians' attitudes toward decision aids.

O’Connor AM, Llewellyn-Thomas et al. Physicians’ opinions about decision aids for patients considering systemic adjuvant therapy for axillary-node negative breast cancer. Patient Educ Couns. 1997;30:143-53.

Developed decision aids for:

• relief from osteoarthritic pain
• treating stage IV lung cancer

1996
Designed the first clinical nursing course focused on decision support skills.

Developed the Decision Regret Scale.

Developed decision aid for: post-menopausal hormones

1995
Established the Patient Decision Aids Research Group (originally called the Ottawa Health Decision Centre - OHDeC) in November.

Developed the Decisional Conflict Scale (DCS): the first scale to measure changes in decisional needs following counseling (uncertainty about a course of action and related modifiable factors such as feeling uninformed, unclear about personal values, and unsupported in decision making); has become a standard for evaluation.

O’Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25-30.

1989
Published a paper describing clinical strategies when a patient presents with decisional needs such as uncertainty about a course of action.

O'Connor, A., & O'Brien-Pallas, L.L. "Decisional Conflict", in G.K. McFarland and E.A. McFarlane (eds), Nursing Diagnosis and Intervention (Toronto: The C.V. Mosby Company, 1989) pp. 573-588.