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Effective Health Care Program

Differing Levels of Clinical Evidence: Exploring Communication Challenges in Shared Decisionmaking

Series Overview

The Eisenberg Center convenes scientific meetings for the discussion of state-of-the-art concepts in communication and medical decisionmaking. Experts in health communication, health literacy, shared decisionmaking, and related fields come together to produce high quality, scholarly white papers (and stakeholder commentaries) that offer insight into how state-of-the-art advances in medical science can be transformed into state-of-the-art clinical decisionmaking and improved health communication.

This conference took place on September 13, 2011, in Gaithersburg, Maryland. Presenters and discussants explored the theory-based and practical approaches to patient-provider communication in order to offer the EHC Program guidance on developing resources and tools that support decisionmaking by patients and their health care providers.


  1. Communicating (Im)Precision and Uncertainty In Clinical Evidence
  2. Eliciting Patients’ Values and Preferences in Decision Making
  3. Supporting Shared Decisions When Clinical Evidence Is Low


The papers presented at the conference were published in Medical Care Research and Review.

Smith QW, Street RL Jr, Volk RJ, et al. Differing levels of clinical evidence: exploring communication challenges in shared decision making. Med Care Res Rev 2013 Feb;70(1 Suppl):3S-13S. PMID: 23223330.

Han PK. Conceptual, methodological, and ethical problems in communicating uncertainty in clinical evidence. Med Care Res Rev 2013 Feb;70(1 Suppl):14S-36S. PMID: 23132891

Zikmund-Fisher BJ. The right tool is what they need, not what we have: a taxonomy of appropriate levels of precision in patient risk communication. Med Care Res Rev 2013 Feb;70(1 Suppl):37S-49S. PMID: 22955699.

Llewellyn-Thomas HA, Crump RT. Decision support for patients: values clarification and preference elicitation. Med Care Res Rev 2013 Feb;70(1 Suppl):50S-79S. PMID: 23124615.

Fraenkel L. Incorporating patients’ preferences into medical decision making. Med Care Res Rev 2013 Feb;70(1 Suppl):80S-93S. PMID: 23132890.

Epstein RM, Gramling RE. What is shared in shared decision making? Complex decisions when the evidence is unclear. Med Care Res Rev 2013 Feb;70(1 Suppl):94S-112S. PMID: 23035055.

Politi MC, Lewis CL, Frosch DL. Supporting shared decisions when clinical evidence is low. Med Care Res Rev 2013 Feb;70(1 Suppl):113S-28S. PMID: 23124616.

Braddock CH 3rd. Supporting shared decision making when clinical evidence is low. Med Care Res Rev 2013 Feb;70(1 Suppl):129S-40S. PMID: 23124617.

McCullough LB. The professional medical ethics model of decision making under conditions of clinical uncertainty. Med Care Res Rev 2013 Feb;70(1 Suppl):141S-58S. PMID: 23124614.