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029 Assessment of shared decision-making levels with the option-5: a systematic review after 10 years of use
  1. Cato C Bresser1,2,3,
  2. Andrea Duarte-Díaz4,5,
  3. Lilisbeth Perestelo-Pérez5,6,
  4. Himar González-Pacheco4,5,
  5. Amado Rivero-Santana4,5,
  6. Yolanda Ramallo-Fariña4,5,
  7. Henrike J Westerink1,2,
  8. Lea M Dijksman1,
  9. Harm H E van Melick3,
  10. Paul van der Nat1,2,
  11. Hugues Vaillancourt7,
  12. France Légaré8,9,
  13. Glyn Elwyn2,10,11,
  14. Mirjam M Garvelink1,2
  1. 1Department of Value Improvement, St. Antonius Hospital, Utrecht, The Netherlands
  2. 2IQ Healthcare, Radboudumc, Nijmegen, The Netherlands
  3. 3Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands
  4. 4Canary Islands Health Research Institute Foundation (FIISC), El Rosario, Spain
  5. 5Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
  6. 6Evaluation Unit (SECS), Canary Island Health Service (SCS), El Rosario, Spain
  7. 7Bureau d’éthique appliquée (BÉA) du Centre hospitalier universitaire de Québec, Laval University, Québec, Canada
  8. 8Canada Research Chair in Shared Decision Making and Knowledge Moblization
  9. 9Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Laval University, Québec, Canada
  10. 10The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, USA
  11. 11University College London, London, UK


Introduction In 2013, the Observing Patient Involvement in Decision Making instrument (OPTION-5) was developed to measure levels of shared decision-making (SDM) in consultations.1 Since then, it has been used in numerous studies. We aimed to synthesize these studies to systematically assess the level of SDM, as measured with the OPTION-5.

Methods A systematic review of studies with OPTION-5 as an outcome. We included all studies that reported OPTION-5 scores, except for studies with simulated patients. Four electronic databases (MEDLINE, EMBASE, Cochrane Library and Web of Science) were searched from 2013 to September 2023. A data extraction form was developed and pilot tested, consisting of data on study, patient and provider characteristics and OPTION-5 scores. Descriptive statistics were used to provide an overview of the characteristics and the mean OPTION-5 score was calculated.

(Preliminary) Results A total of 52 studies were included. The majority were published since 2020 (n=35, 68%) and originated from the Netherlands (n=19, 37%) or the United States (n=18, 35%). The most common conditions studied were multiple conditions (n=18, 35%) or a single oncological condition (n=11, 21%). The mean OPTION-5 score across all studies was 36/100 (range 5.5–83.0).

Discussion This is the first systematic review to report this level as measured by OPTION-5. A previous review has assessed the level of SDM as measured by a different instrument (the OPTION-12, the predecessor to OPTION-5) and found a mean of 23/100.2 Hence, our results (36/100) suggest a positive trend in the level of SDM.

Conclusion(s) These results provide a basis for further exploration of trends in SDM-levels and variations within different subgroups, contributing to a better understanding of OPTION-5 scores. We are currently conducting a meta-analysis to calculate the average score per subgroup and to investigate a threshold for clinically significant SDM.


  1. Elwyn G, Tsulukidze M, Edwards A, Légaré F, Newcombe R. Using a ‘talk’ model of shared decision making to propose an observation-based measure: Observer OPTION 5 Item. Patient Educ Couns. 2013 Nov;93(2):265–71.

  2. Couët N, Desroches S, Robitaille H, Vaillancourt H, Leblanc A, Turcotte S, Elwyn G, Légaré F. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument. Health Expect. 2013 Aug;18(4):542–61.

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