18. Lessons learnt User-centered design happens in the field, takes multiple iterations and expertise. Testing decision aids in usual clinical settings is tough: decision moments are unpredictable. Repeated use for chronic decisions has been difficult to study in efficacy trials.
19. Myths Goal and settings Decision aids have no role in evidence-based care Decision aids support shared decision making Valid decision aids cannot be used in busy clinical settings, such as primary care Participants Clinicians would not want to use decision aids – they are barriers to adoption of SDM Acutely ill patients are not good targets for SDM Elderly chronically ill patients cannot participate in SDM
20. Summary of 5 years of work 13 wiser choices decision aids Chronic and acute care Primary and specialty care Rural, urban, and academic 50+ sites 200+ clinicians 600+ patients In trials!