Ottawa Decision Support Framework (ODSF)

The Ottawa Decision Support Framework is an evidence-based, practical, mid-range theory for guiding patients making health or social decisions. It uses a three-step process to:

1. assess client and practitioner determinants of decisions to identify decision support needs;
2. provide decision support tailored to client needs; and
3. evaluate the decision making process and outcomes.

It is based on concepts from general psychology (Tversky & Kahneman, 1981), social psychology (Ajzen & Fishbein, 1980), decision analysis (Keeney & Raiffa, 1976), decisional conflict (Janis & Mann, 1977), social support (Norbeck, 1988; Orem, 1995), and economic concepts of expectations and values (Feather, 1980).

The ODSF has been used to guide the development and evaluation of more than 30 patient decision aids, practitioner decision support resources, and tools to evaluate the quality and outcomes of providing decision support.

References discussing the ODSF:

1. O'Connor AM, Jacobsen MJ. Decisional Conflict: Supporting people experiencing uncertainty about options affecting their health [PDF monograph on the Internet]. Ottawa: Ottawa Health Decision Centre; 2007.
2. Murray MA, Miller T, Fiset V, O'Connor AM, & Jacobsen MJ. Decision support: helping patients and families to find a balance at the end of life. International Journal of Palliative Nursing. 2004 Jun;10(6):270-7.
3. O'Connor AM, Tugwell P, Wells G, Elmslie T, Jolly E, & Hollingworth G. A decision aid for women considering hormone therapy after menopause: Decision support framework and evaluation. Patient Education & Counseling. 1998 Mar;33(3):267-279.
4. O'Connor A, Jacobsen MJ, & Stacey D. An evidence-based approach to managing women's decisional conflict. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2002 Sep-Oct;31(5):570-581