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History of scientific research on the Decision Box
We have designed the site you are currently viewing and the decision support tools presented, for the purpose of studying them during research projects. Even if some of the displayed Decision Boxes are outdated, we keep them on this site to allow you to see them and appreciate their various formats.
The first decision box template was based on the "Drug Facts Box", a tool developed by Drs. Lisa Schwartz and Steven Woloshin of Dartmouth University. The Drug Facts Box aims to facilitate consumer access to evidence on the effects of drugs and has been inspired by Nutrition Facts Tables displayed on food packaging.
A first study evaluated this template with patients and physicians. Two publications present this research:
- Giguere A, Legare F, Grad R, Pluye P, Rousseau F, Haynes RB et al. Developing and user-testing Decision boxes to facilitate shared decision making in primary care - a study protocol. BMC Med Inform Decis Mak. 2011;11:17-26.
- Giguere A, Legare F, Grad R, Pluye P, Haynes RB, Cauchon M et al. Decision boxes for clinicians to support evidence-based practice and shared decision making: the user experience. Implement Sci. 2012;7:72.
An improved version of the Decision Box was designed based on the results of the first project. We then created 8 Decision Boxes using this enhanced template, in both French and English. A research project then studied the barriers and facilitators to using Decision Boxes in clinical practice. More specifically, we described the factors influencing implementation that arose from the Decision Boxes themselves, the primary health care team and the practice environment in the following publications:
- Giguere A, Labrecque M, Grad R, Cauchon M, Greenway M, Legare F et al. Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decision making: a study protocol. BMC Med Inform Decis Mak. 2012;12:85.
- Giguere A, Labrecque M, Haynes R, Grad R, Pluye P, Legare F et al. Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study. Implement Sci. 2014;9(1):144.
- Giguere AMC, Labrecque M, Légaré F, Grad R, Cauchon M, Greenway M et al. Feasibility of a randomized controlled trial to evaluate the impact of Decision Boxes on Shared Decision Making processes. BMC Med Informatics Decision Making. 2015;15(13).
In the previous two projects, health professionals have distributed Decision Boxes to their patients, despite the fact that they were intended for their own training. Therefore, we have started to develop separate versions for health care professionals and for patients. For this purpose, we have asked patients and health care professionals to advise us in adapting the Decision Box to meet their respective needs. This work is described in the following publications:
- Giguere AMC, Lawani MA, Fortier-Brochu É, et al. Tailoring and evaluating an intervention to improve shared decision-making among seniors with dementia, their caregivers, and healthcare providers: study protocol for a randomized controlled trial. Trials. 2018;19(1):332.
- Poirier A, Voyer P, Légaré F, et al. Caring for seniors living with dementia means caring for their caregivers too. Can J Public Heal. 2018;108(5-6):639.
- Lawani MA, Valéra B, Fortier-Brochu É, Légaré F, Carmichael P-H, Côté L et al. Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers. Systematic reviews. 2017;6(56):1-12.
- Bilodeau G, Witteman HO, Légaré F, Lafontaine-Bruneau J, Voyer P, Kröger E, Tremblay M-C and Giguere AMC. 2019. Reducing Complexity of Patient Decision Aids for Community-Based Older Adults with Dementia and Their Caregivers: Multiple Case Study of Decision Boxes. BMJ Open, 9(5): e027727
- Lawani MA, Turgeon Y, Côté L, Légaré F, Witteman HO, Morin M, Kröger E, Voyer P, Rodríguez C and Giguere AMC. User-Centered and Theory-Based Design of a Professional Training Program on Shared Decision Making with Older Adults Living with Neurocognitive Disorders: A Mixed-Methods Study. Submitted.
- Lawani MA, Côté L, Coudert L, Morin M, Witteman H, Caron C, Kröger E, Légaré F, Rodriguez C, Voyer P and Giguere. Professional Training on Shared Decision Making with Older Adults Living with Neurocognitive Disorders: A Mixed-Methods Implementation Study, Submitted.
2019: A single Decision Box for both the patients and health care professionals, in printable and web-based versions
Inspired by the comments received during the previous study, several graphic designers joined the team to enhance the new Decision Box template by incorporating images and icons for easy reading. We also asked the opinion of health professionals to improve this version, since we are asking them to use the Decision Box during their consultations. Lastly, we also designed an interactive version of the Decision Box (which is available on this webiste, click here).
The current study will show whether access to the Decision Boxes in printable and interactive versions can foster the adoption of shared decision-making in family medicine clinics in three Canadian provinces, namely Quebec, Ontario and Alberta.
- Bogza L, Patry-Lebeau C, Farmanova E, Witteman HO, Elliott J, Stolee P, Hudon C and Giguere AMC. 2020. Design of a Web-Based Decision Aid to Support Explicit Values Clarification and Informed Decision Making of Older Adults with Mild Cognitive Impairment and Their Healthcare Providers. JMIR: accepted with revisions.