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061 Patient involvement in decision making: an updated systematic review of studies using the option-12 instrument
  1. Andrea Duarte-Díaz1,2,
  2. Cato C Bresser3,4,5,
  3. Mirjam M Garvelink3,4,
  4. Himar González-Pacheco1,2,
  5. Amado Rivero-Santana1,2,
  6. Yolanda Ramallo-Fariña1,2,
  7. Henrike J Westerink3,4,
  8. Lea M Dijksman3,
  9. Harm H E van Melick5,
  10. Paul van der Nat3,4,
  11. Hugues Vaillancourt6,
  12. France Légaré7,8,
  13. Glyn Elwyn9,10,
  14. Lilisbeth Perestelo-Pérez2,11
  1. 1Canary Islands Health Research Institute Foundation (FIISC), El Rosario, Spain
  2. 2Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
  3. 3Department of Value Improvement, St. Antonius Hospital, Utrecht, The Netherlands
  4. 4IQ Healthcare, Radboudumc, Nijmegen, The Netherlands
  5. 5Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands
  6. 6Bureau d’éthique appliquée (BÉA) du Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
  7. 7Canada Research Chair in Shared Decision Making and Knowledge Moblization
  8. 8Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Laval University, Québec, Canada
  9. 9The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, US
  10. 10University College London, London, UK
  11. 11Evaluation Unit (SESCS), Canary Islands Health Service (SCS), El Rosario, Spain


Introduction A decade has passed since Couët et al. (2013)1 provided the first comprehensive exploration of the extent to which healthcare providers involve patients in decision- making. The evolving nature of patient involvement practices emphasizes the imperative for an updated review of studies using the OPTION-12 scale2 to identify the state of the knowledge and remaining gaps.

Methods An updated systematic review was conducted, following the PRISMA statement. Four electronic databases (MEDLINE, Embase, Cochrane Library and Web of Science) were consulted, from 2012 to September 2023. Observational and experimental studies were included. Data extraction covered study details, patients, providers and consultations’ characteristics and OPTION-12 scores. Two reviewers independently conducted screening and extraction. Descriptive statistics were used to summarize the studies’ characteristics, and the mean OPTION-12 score was calculated.

Preliminary Results One hundred and four eligible studies were identified, with 75 of them published after Couët’s review.1 Most studies were conducted in the United States (n = 31, 30%), the United Kingdom (n = 14, 13%), and The Netherlands (n = 13, 13%). A substantial proportion of studies (27%) addressed multiple health conditions, and the most represented specific areas were oncological (16%), mental health (12%) and cardiovascular care (11%). Mean total scores ranged from 3 to 74 on a 0–100 scale, with an overall mean of 28.

Discussion A decade after the first systematic review in this field, our preliminary results reveal persistently low levels of patient-involvement behaviors, with only a marginal increase in the overall OPTION-12 mean score.

Conclusions These findings set the stage for a more in-depth exploration of patient involvement trends and variations. The forthcoming phase involves a meta- analysis for a weighted average score, exploring how various factors might influence total scores through subgroup analyses and metaregression.


  1. 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;18(4):542–61.

  2. Elwyn G, Hutchings H, Edwards A. et al. The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks. Health Expect. 2005;8(1):34–42.

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