Conceptual model
This project is guided by a tailored version of a published SDM
framework23(Figure 1) . This model outlines the constructs necessary to
measure decision quality, defined as “the extent to which patients are
informed, meaningfully involved in the decision-making process, and
receive tests and treatments that reflect their goals and
concerns.”23The model specifies key stakeholders and processes, which include
consultations, care being delivered, and outcomes, with feedback loops
relaying evidence about outcomes to inform future decisions. Decision
antecedents include characteristics of the patients and caregivers,
clinicians, and health system that influence the decision-making
process, such as patient health literacy, clinician communication
skills, and availability of decision aids in a health system. Relevant
factors of the decision-making process include patient sociodemographic
characteristics (including preferred language) and literacy levels,
level of patient engagement in the consultation, decisional conflict and
deliberation processes, the use of decision aids or other resources, and
discussions of risks and benefits. After the care is delivered, relevant
outcomes relate to the decision specifically (such as decision regret)
and to the health outcomes after ablation (in this case, resolution of
symptoms and restoration of normal cardiac rhythm).