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Do choosing wisely tools meet criteria for patient decision aids? A descriptive analysis of patient materials
  1. France Légaré1,2,
  2. Jessica Hébert1,
  3. Larissa Goh1,
  4. Krystina B Lewis3,
  5. Maria Ester Leiva Portocarrero1,
  6. Hubert Robitaille1,
  7. Dawn Stacey3,4
  1. 1Canada Research Chair in Shared Decision Making and Knowledge Translation, Research Axis of Population Health and Practice-Changing Research, CHU de Québec Research Centre, Saint-François-d'Assise Hospital, Quebec City, Quebec, Canada
  2. 2Department of Family Medicine and Emergency Medicine, Pavillon Ferdinand-Vandry, Quebec City, Quebec, Canada
  3. 3Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
  4. 4Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  1. Correspondence to Dr France Légaré; france.legare{at}


Objectives Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids.

Design Descriptive analysis of all Choosing Wisely Canada patient materials.

Data source In May 2015, we selected all Choosing Wisely Canada patient materials from its official website.

Main outcomes and measures Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted.

Results Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8–11) for screening topics and 6/12 (range: 6–9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria.

Conclusions Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools.

  • Choosing Wisely
  • Patient decision aids (PtDAs)
  • Shared decision making (SDM)

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