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2013 November Supplement in BMC Medical Informatics and Decision Making.
The International Patient Decision Aid Standards (IPDAS) Collaboration’s Quality Dimensions: Theoretical Rationales, Current Evidence, and Emerging Issues.

This 2013 series begins with a paper describing a) the ten-year evolution of the IPDAS Collaboration itself and b) IPDAS's 12 core dimensions for assessing the quality of patient decision aids. Next, 12 papers present an updated theoretical rationale, the current empirical evidence, and the emerging issues underlying each of these core evaluative dimensions. Finally, the series closes with a systematic review of the implementation of patient decision support interventions into routine clinical practice. A total of 102 authors from 10 countries contributed to this supplement.

2013 Update of the IPDAS Story
An update to the overview of the activities of the International Patient Decision Aid Standards (IPDAS) Collaboration originally presented at the 2011 International Shared Decision Making Conference held in Maastricht, Netherlands.
2013 IPDAS email list
The IPDAS email list, IPDAS@listserv.dartmouth.edu, will be used:
  1. as a membership register,
  2. to communicate,
  3. to agree on a process to convene a Steering Group (vote for chair/members),
  4. for future research / development of the criteria.
To be added, ask a current member to introduce you by citing your interest and expertise relevant to IPDAS. If you don’t know a member, see the Who’s Involved? page.
2012 Update of the IPDAS Collaboration Background Document


Chapter A: Using a Systematic Development Process

Chapter B: Providing Information About Options

Chapter C: Presenting Probabilities

Chapter D: Clarifying and Expressing Values

Chapter E: Using Personal Stories

Chapter F: Guiding / Coaching in Deliberation and Communication

Chapter G: Disclosing Conflicts of Interest

Chapter H: Delivering Decision Aids on the Internet

Chapter I: Balancing The Presentation of Information and Options

Chapter J: Addressing Health Literacy

Chapter K: Basing Information On Comprehensive, Critically Appraised, And Up-To-Date Syntheses Of The Scientific Evidence

Chapter L: Establishing the Effectiveness

Implementation of Patient Decision Support Interventions into Routine Clinical Practice: A Systematic Review
Provide Suggestions for IPDAS Quality Dimensions
2009 IPDASi
An instrument to assess the quality of patient decision support technologies.
2006 IPDAS Checklist for Judging the Quality of Patient Decision Aids [116KB PDF]
2006 The IPDAS Collaboration results have been published:
Glyn Elwyn, Annette O’Connor, Dawn Stacey, Robert Volk, Adrian Edwards, Angela Coulter, Richard Thomson, Alexandra Barratt, Michael Barry, Steven Bernstein, Phyllis Butow, Aileen Clarke, Vikki Entwistle, Deb Feldman-Stewart, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Nora Moumjid, Al Mulley, Cornelia Ruland, Karen Sepucha, Alan Sykes, Tim Whelan, on behalf of the International Patient Decision Aids Standards (IPDAS) Collaboration. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. British Medical Journal. 2006 Aug 26;333(7565):417.
2005 IPDAS Collaboration Reaches Consensus On Indicators For Judging the Quality of Patient Decision Aids [297KB PDF]
Presented at the 27th Annual Meeting of the Society for Medical Decision Making (October 21-24, 2005) San Francisco, CA, USA.
2005 Second Round Voting Document [377KB PDF]
  • This revised voting document also includes:
    • A summary of the 1st round results for the 12 broad criteria
    • The equimedian score for each of the 80 criteria in the 1st round of voting. Equimedians were calculated to equalise the effect of the different voter numbers in the 4 key stakeholder groups (policy maker / health plan administrators, patients / consumer representatives, health practitioners, decision aid developers/researchers)
    • The frequency counts of the 1 to 9 ratings for each of the 80 criteria in the 1st round of voting
  • This document was used to revise the voting website and as a PDF document available on the voting website for those preferring to vote on paper.
  • Voters were asked consider the results from the 1st round of voting when re-voting on the importance of each criterion for judging the quality of a patient decision aid.
2005 First Round Voting Document [313KB PDF]
  • A collection of summary statements for each of the 12 broad criteria with a total of 80 voting items.
  • This document was used to create the voting website at Baylor College of Medicine (B Volk and colleagues) and was available as a PDF on the voting website for those preferring to vote on paper.
  • Voters were asked to vote on the importance of each criterion when judging the quality of a patient decision aid.
2005 Original IPDAS Collaboration Background Document [414KB PDF]
  • A summary of the definitions as well as theoretical and empirical links between each of the 12 broad quality criteria and decision quality.
  • The 12 broad criteria include: systematic development process, information on options, presenting probabilities, clarifying values, patient stories, disclosing conflicts of interest, delivering decision aids on the Internet, balanced presentation of options, using plain language, information based on scientific evidence, establishing effectiveness.
  • The primary evidence sources were the Cochrane Review of 34 randomized controlled trials evaluating patient decision aids with real patients facing health decisions (2003 update) and fundamental studies.
  • This document was used to inform the summary statements for each of the 12 broad categories and the identification of the original set of voting criteria.
  • It was available during the voting process for voters interested in learning more about the 12 broad criteria.
Very useful for training students. I ask them to "vote using the 1st round document, then give them feedback using 2nd round document results." As well, students developing patient decision aids find the background document very useful.

A O'Connor PhD, Professor at the University of Ottawa (June 2005)
I teach a research course about the theories, study designs, and methods used to study patients' decision making. The course includes, but isn't confined to, the topic of Shared Decision Making/Patients' Decision Aids (SDM/PtDAs). The individual sections of the IPDAS Collaboration Background Document are rich reading resources for the students, as we move through the different topic areas of the course. For example, the principles outlined in Section B (providing information about therapeutic options) and in Section C (presenting probabilities) are highly relevant to problems outside the SDM/PtDA context, such as developing ways to measure the Minimal Clinically Important Difference that patients would want from a new therapy that's going to be assessed in a clinical trial.

H Llewellyn-Thomas PhD, Professor at Dartmouth Medical School (June 2005)

Related Publications

Feldman-Stewart D, Brennenstuhl S, McIsaac K, Austoker J, Charvet A, Hewitson P, Sepucha KR & Whelan T. A Systematic Review of Information in Decision Aids. Health Expectations 10 (1), 46–61. 2007.

Washington State Legislature Health Care bill includes decision aids. SB 5930 - 2007-08 Providing high quality, affordable health care to Washingtonians based on the recommendations of the blue ribbon commission on health care costs and access. August 2007.

Decision Quality
Sepucha, KR, Fowler, FJ, & Mulley, AG. Policy support for patient-centered care: The need for measurable improvements in decision quality. Health Affairs. 2004.

Risk Communication
Trevena L, Davey HM, Barratt A, Butow P, Caldwell P. A systematic review on communicating with patients about evidence. Journal of Evaluation in Clinical Practice. 2006.

Barratt A, Trevena L, Davey HM, & McCaffery, K. Use of decision aids to support informed choices about screening. British Medical Journal, 329, 507-510. 2004.

Values Clarification
O'Connor AM, Stacey D, Tugwell P, & Guyatt G. Incorporating patient values. In A DiCenso, G Guyatt, & D Ciliska (Eds.), Evidence-based nursing: A guide to clinical practice. Toronto: Mosby. 2005.

Last modified: 2013-11-29.

© 2013 IPDAS Collaboration.    Email questions or comments to ipdas@ohri.ca.