• David W Chambers.
• University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
• J Eval Clin Pract. 2023 Oct 1; 29 (7): 106110671061-1067.

RationaleShared decision making has been widely advocated and evaluated in diverse ways for 4 decades.Aims And ObjectivesBut there is scant evidence that it is commonly accepted by or has influence on practitioners' behaviour or that it positively affects patient health outcomes. This situation may be due in part to the absence of a commonly agreed operational definition of the construct. This is admitted in the literature and has led to multiple approaches to evaluation.MethodAn operational definition is proposed based on ethical parity among parties, sharing of mutually interacting expectations and analysis of decisions as commitment to action rather than information.ResultsShared decision making occurs when two autonomous and uncoerced agents both commit to actions that neither has reason to want to change based on their understanding of anticipated outcomes given the situation at hand and of the intended actions of the other party.ConclusionIt is a broader concept than providing information regarding treatment alternatives in the office.© 2022 John Wiley & Sons Ltd.

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