'What happens if I do nothing?' A Systematic Review of the Inclusion and Quantitative Description of a 'No Active Intervention' Option in Patient Decision Aids

Tammy Hoffmann, Julia Beckhaus, Chris Del Mar

Research output: Contribution to journalReview articleResearchpeer-review

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Abstract

The tendency of patients and clinicians to overestimate intervention benefits is an acknowledged contributor to healthcare overuse.1,2 For many conditions, not actively intervening is a legitimate option, such as for self-limiting conditions which can resolve without intervention (other than for symptom management), for conditions where ‘wait and watch’ is appropriate, or where not having a screen or test is reasonable. As part of shared decision-making and campaigns such as Choosing Wisely,3 patients are encouraged to ask ‘what happens if I do nothing?’. To help patients construct informed preferences and decisions congruent with their values, part of a decision aid’s role can be to correct misperceptions about the benefits and harms of intervention options, including not intervening.4 For conditions where not actively intervening is reasonable, informed decision-making requires discussion about the condition’s natural history, such as timeframes to recovery or other likely consequences. We aimed to analyze the inclusion and quantitative description of a ‘no active intervention’ option in all publicly available decision aids.
Original languageEnglish
Number of pages3
JournalJournal of General Internal Medicine
Early online date2 Feb 2021
DOIs
Publication statusE-pub ahead of print - 2 Feb 2021

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