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Pediatrics. 2018 Nov;142(Suppl 3):S157-S162. doi: 10.1542/peds.2018-0516F.

Pragmatic Strategies for Shared Decision-making.

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Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.


Shared decision-making (SDM) is a process that brings together clinical expertise and families' values to arrive at a treatment choice. The process is especially useful for situations with >1 reasonable option, a condition of equipoise. However, for pediatricians who want to adhere to SDM best practices, there is limited practical guidance regarding how to communicate with parents and patients. With the following text, we describe pragmatic strategies to support SDM around both high-stakes decisions in the acute setting as well as in the ongoing management of chronic conditions in settings such as primary care.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Fiks’ research team was supported by a Pfizer Independent Research Grant for work related to developing software to support shared decision-making in attention-deficit/hyperactivity disorder. He did not personally receive salary support; and Drs Walter and Hwang have indicated they have no potential conflicts of interest to disclose.

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