Article Text

Download PDFPDF
098 Purposeful SDM: theoretically, empirically, practically, and analytically
  1. Misk Al Zahidy1,
  2. Victor Montori1,2,
  3. Montserrat León-García3,
  4. Ian Hargraves1
  1. 1Knowledge and Evaluation Research Unit, Mayo Clinic, Minnesota, USA
  2. 2Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Minnesota, USA
  3. 3Iberoamerican Cochrane center, Hospital de la Santa Creu i Sant Pau, Spain


Purposeful Shared Decision Making (pSDM) envisions SDM as a shared endeavor to co-produce a way forward and argues there are multiple distinct SDMs needed to tackle different problematic situations. This symposium explores pSDM through theory, empirical evidence, practical application, and measurement. We illuminate the complex layers and nuanced challenges inherent in caring for and living with illness, offering a pragmatic and rounded understanding of SDM’s role in co-producing care designed to fit patients’ unique lives.

Segment one introduces pSDM’s theoretical origins and four modes of pSDM connecting different types of problematic situations, deliberative methods, and decisive topics. (table)

Next, we review empirical studies showing the presence and variation of pSDM modes in encounters. These findings underscore the importance of flexibility and adaptation of SDM to each patient‘s particular situation.

Building on this, we consider SDM as a foundational method of care and offer practical approaches for collaborating to produce individualized, sensible, evidence-based care plans that are desirable, feasible, and sustainable.

Having established in theory, observation, and practice the existence and importance of using SDM in different ways according to the patient’s situation (pSDM), we review the capacity of observer measures to detect multiple forms of SDM and discuss current work to measure the occurrence of patients and clinicians endeavoring to co-produce a way forward in the patient’s medical and life situation (SDM).

Concluding discussion will synthesize these diverse aspects and foresee the potential of pSDM in practice, research directions, challenges, and place in modern healthcare.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.