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March 13, 2020

When Guidelines Recommend Shared Decision-making

Author Affiliations
  • 1O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
  • 3Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
JAMA. 2020;323(14):1345-1346. doi:10.1001/jama.2020.1525
JAMAevidence: Users' Guides to the Medical Literature (31:25)
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Clinicians and patients may develop care plans from clinical practice guidelines. To be trustworthy, guidelines should result from a rigorous, inclusive, and transparent process, informed by the best available research evidence and safeguarded against biases and conflicts of interest.1 Their guidance should be clear, specific, graded by likelihood of benefit and harm, and actionable. Guidelines are increasingly recommending shared decision-making (SDM),2 an approach in which patients and clinicians work together to develop a shared appreciation of the patient’s situation and decide how to respond well to it.3 The increasing recommendation of SDM in guidelines is problematic insofar as the extent to which the guideline recommendations are reliable, useful, usable, and desirable remains unclear.

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