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Development and Evaluation of Health-Care Decision Aids
Annette O'Connor, R.N., Ph.D., is internationally recognized for helping make such complex decisions easier. She has designed more than 30 patient decision aids that help prepare you to discuss which benefits and risks matter most to you with your doctor and family. For example, when simpler treatments are not controlling your symptoms completely [hot flashes, arthritis or back pain, stomach acid reflux, acne, depression] do you take a more aggressive treatment that works better but has serious risks? For early stage prostate cancer treatments with equal survival benefits but different harms, which harms are you most concerned about…the extra risk of incontinence/impotence from surgery or bowel problems from radiation?
Dr O'Connor has also developed new skills that practitioners need to support patients' decision making….such as monitoring patients' decisional conflict, communicating probabilities, clarifying values, and coaching patients in 'shared' decision making to reach agreement on the best choice. The best choice, says O'Connor is one that matches the features that matter most to the 'informed' patient.
Dr. O'Connor is collaborating with health care providers and researchers around the world to develop decision aids for difficult decisions such as whether or not to: take more aggressive treatments for hot flashes, osteoarthritis, or back pain; have a repeat cesarean section; have a feeding tube inserted in a cognitively impaired older relative. Since there will never be a decision aid for every difficult decision, she has developed a generic 'Ottawa Personal Decision Guide' to help people identify what makes a decision difficult for them [inadequate knowledge, values clarity or support] and what they can do about it.
Dr. O'Connor also leads the International Cochrane Collaboration team that summarizes all trials of patient decision aids (over 62) and that updates a global inventory of evaluated patient decisions aids (over 500 that are hosted at OHRI http://www.ohri.ca/decisionaid). She co-leads a 14 country international consensus process on standards for developing and evaluating patient decision aids (IPDAS). She is a fellow of the prestigious Canadian Academy of Health Sciences and has been recognized for her work by awards such as the Society for Medical Decision Making John Eisenberg Award for Exemplary Leadership, 2005 University of Ottawa Researcher of the Year and the 2006 Ottawa Life Sciences Council Health Innovation Award .
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