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The goal of evidence-based healthcare is to integrate clinical expertise with patients' values using the best available evidence. However, many decisions fall in the “gray zone,” because the benefit-harm ratios either are unknown or depend on how patients value them. For example, should patients take a more aggressive treatment when simpler therapies fail to control moderate or severe symptoms of menopause, osteoarthritis, benign prostatic hyperplasia, back pain, benign uterine bleeding, or stable angina? Other complex decisions include genetic testing, reproductive choices, treatment of early breast and prostate cancer, and the intensity and location of care at the beginning and end of life.

To prepare patients for discussion of these options, patient decision aids (PtDAs) have been developed as adjuncts to counseling. This entry defines PtDAs, ...

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