Shared Decision Making – The Importance of Diagnosing Preferences

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Shared decision making occurs when patients and clinicians reach a formulation about the presenting problem and discuss how to manage it. If there are several reasonable alternatives, the alternatives should be explicitly compared, using evidence about relevant harms and benefits. Such decisions should be informed by knowledge about the patients’ condition, about the evidence applicable to it, and the patient’s goals and preferences. Eliciting patients’ views has been referred to as making a preference diagnosis,1 and eliciting it requires a blend of science and interpersonal skills.

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