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).