• Home
  • Guideline
  • Implementation
    • The Project
    • The Project Team
    • Advisory Board
  • Publications
  • Contact
  • enEnglish
    • deDeutsch

Using value clarification tools

Home Guideline Using value clarification tools

Introduction

Since health information is intended to support patients and citizens in the process of shared decision-making, their personal values and preferences play an important role in the decision-making process (1). To support this group of people in the clarification of their individual values and preferences, value clarification tools are used as part of decision aids (2). This includes various methods and strategies designed to help users to gain clarity about their personal values and preferences regarding medical interventions and to communicate these in order to reach a decision the outcome of which is consistent with their personal values and preferences (2).

Generally, explicit and implicit value clarification tools are differentiated. The user of implicit value clarification tools only thinks about what is important for his/her own decision. The users of explicit value clarification tools are involved in an interactive process in which attributes that are decisive for the therapy or diagnostic option are reflected on and evaluated with regard to their subjective importance on a rating scale (1, 3). Since evidence-based health information should generally be required to present different options in such a way that they enable an implicit clarification of preferences, the focus here is on explicit value clarification tools. In the process, it will be discussed whether value clarification tools improve the decision-making process (1, 2).

The developers use various formats based on different theories (e.g. the Differentiation and Consolidation Theory, Fuzzy Trace Theory) (4). Typical representations are similar to a scale with positive attributes (benefits) on the one side and negative attributes (risks) on the other side, which are evaluated by the patients in their subjective importance, resulting in a preference for or against a therapy option according to the given preferences (1). Another possibility are rating and ranking exercises in which predetermined attributes are sorted according to the subjective importance. Each attribute is then classified according to how much it influences the actual decision. Finally, the patient receives an evaluation of his/her assigned preferences, which illustrate the tendency to a certain option (5).

Question

  1. What effects do value clarification tools in health information have?
Recommendation
Evidence table
Full text
References
  1. O’Connor AM, Wells GA, Tugwell P, Laupacis A, Elmslie T, Drake E. The effects of an ‘explicit’ values clarification exercise in a woman’s decision aid regarding postmenopausal hormone therapy. Health expectations. 1999; http://onlinelibrary.wiley.com/o/cochrane/
    clcentral/articles/046/CN-00414046/frame.html
    (Zugriff am 13.10.2016).
  2. Fagerlin A, Pignone M, Abhyankar P, Col N, Feldman-Stewart D, Gavaruzzi T, et al. Clarifying values: an updated review. BMC medical informatics and decision making. 2013;13 Suppl 2:S8. Epub 2013/01/01.
  3. Abhyankar P, Bekker HL, Summers BA, Velikova G. Why values elicitation techniques enable people to make informed decisions about cancer trial participation. [References]. Health Expectations: An International Journal of Public Participation in Health Care & Health Policy. 2011;14(Suppl 1):20-32.
  4. Pignone M, Fagerlin A, Abhyankar P, Col N, Feldman-Stewart D, Gavaruzzi T, et al. Clarifing and expressing values. In Volk R & Llewellyn-Thomas H (eds.) 2012. Update of the International Patient Decision Aids Standards (IPDAS) Collabporation’s Background Document. Chapter D.
  5. Sheridan SL, Griffith JM, Behrend L, Gizlice Z, Jianwen C, Pignone MP. Effect of adding a values clarification exercise to a decision aid on heart disease prevention: a randomized trial. Medical decision making: an international journal of the Society for Medical Decision Making. 2010;30(4):E28-39. Epub 2010/05/21.
  6. Garvelink MM, ter Kuile MM, Stiggelbout AM, de Vries M. Values clarification in a decision aid about fertility preservation: does it add to information provision? BMC medical informatics and decision making. 2014;14:68. Epub 2014/08/12.
  7. Feldman-Stewart D, Brennenstuhl S, Brundage MD, Roques T. An explicit values clarification task: Development and validation. [References]. Patient Education and Counseling. 2006;63(3):350-6.
  8. Achaval S, Fraenkel L, Volk RJ, Cox V, Suarez-Lmazor ME. Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty. Arthritis care & research. 2012; http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/ 011/CN-01018011/frame.html (Zugriff am13.10.2016).
  9. Feldman-Stewart D, Tong C, Siemens R, Alibhai S, Pickles T, Robinson J, et al. The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: evidence from a randomized controlled trial. Medical decision making: an international journal of the Society for Medical Decision Making. 2012;32(4):616-26. Epub 2012/01/31.

© 2014-2017 Leitlinie Gesundheitsinformation

  • Contact
  • Disclaimer & Privacy Policy
  • Imprint