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BMJ Qual Saf. 2018 May;27(5):389-412. doi: 10.1136/bmjqs-2017-006985. Epub 2018 Feb 21.

Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature.

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Department of Family Medicine and Emergency Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.
The Reaching for High Value Care Team, Chapel Hill, North Carolina, USA.
Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada.
Research (April 2014-November 2016), Healthwise Incorporated, Boston, Massachusetts, USA.
Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Health Sciences and Psychological Sciences, University of Missouri Health, Columbia, Missouri, USA.
Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
Health Evidence, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
College of Nursing, Ohio State University, Columbus, Ohio, USA.
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.


This Explanation and Elaboration (E&E) article expands on the 26 items in the Standards for UNiversal reporting of Decision Aid Evaluations guidelines. The E&E provides a rationale for each item and includes examples for how each item has been reported in published papers evaluating patient decision aids. The E&E focuses on items key to reporting studies evaluating patient decision aids and is intended to be illustrative rather than restrictive. Authors and reviewers may wish to use the E&E broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.


checklists; patient education; patient-centred care; shared decision making

Conflict of interest statement

Competing interests: KRS receives salary support as a scientific advisory board member for the Informed Medical Decisions Foundation, now part of Healthwise, a not-for-profit organisation that develops patient decision aids. VS received personal fees from Merck Pharmaceuticals. During the last 36 months, SS has received funding from the Agency for Health Services Research and Quality for a scoping review to identify a research agenda on shared decision making and high value care. During this time, she also completed unfunded research or papers on patient decision aid evaluations and developed the Reaching for High Value Care toolkit, a toolkit of evidence briefs and resources on patient-centred high value care for all levels of system leaders. As part of those efforts and efforts on the current manuscripts, SS has developed a series of research resources on reporting research. She is considering the potential benefits and harms of pursuing intellectual property protection for some of these efforts, but has not initiated these to date.

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