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Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature
  1. Aubri S Hoffman1,2,
  2. Karen R Sepucha3,
  3. Purva Abhyankar4,
  4. Stacey Sheridan5,
  5. Hilary Bekker6,
  6. Annie LeBlanc7,
  7. Carrie Levin8,
  8. Mary Ropka9,
  9. Victoria Shaffer10,
  10. Dawn Stacey11,12,
  11. Peep Stalmeier13,
  12. Ha Vo14,
  13. Celia Wills15,
  14. Richard Thomson16
  1. 1 Department of Family Medicine and Emergency Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2 Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3 Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
  4. 4 Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
  5. 5 The Reaching for High Value Care Team, Chapel Hill, North Carolina, USA
  6. 6 Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
  7. 7 Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada
  8. 8 Research (April 2014-November 2016), Healthwise Incorporated, Boston, Massachusetts, USA
  9. 9 Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
  10. 10 Health Sciences and Psychological Sciences, University of Missouri Health, Columbia, Missouri, USA
  11. 11 Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
  12. 12 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
  13. 13 Health Evidence, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
  14. 14 Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  15. 15 College of Nursing, Ohio State University, Columbus, Ohio, USA
  16. 16 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Professor Richard Thomson, Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; richard.thomson{at}


This Explanation and Elaboration (E&E) article expands on the 26 items in the Standards for UNiversal reporting of Decision Aid Evaluations guidelines. The E&E provides a rationale for each item and includes examples for how each item has been reported in published papers evaluating patient decision aids. The E&E focuses on items key to reporting studies evaluating patient decision aids and is intended to be illustrative rather than restrictive. Authors and reviewers may wish to use the E&E broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items.

  • shared decision making
  • patient-centred care
  • checklists
  • patient education

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Handling editor Kaveh G Shojania

  • Contributors The editorial writing team was led by KS and RT and included PA and AH. All listed authors contributed substantially to the writing of the manuscript. Each author was assigned and led drafting of specific items, and had the opportunity to review the manuscript prior to its submission. RT and AH were the leads for the manuscript and contributed to the conceptualisation, organisation and overall editing of the manuscript; preparation of the background and summary; and preparation of the appendices. SLS contributed additional review and summary of the evidence for the items.

  • Funding The in-person work group meetings were supported through grants from the United Kingdom’s Health Foundation (grant # 7444 Thomson PI) and the Agency for Healthcare Research and Quality’s Small Conference grant (1R13HS024250-01 Sepucha PI). ASH is funded by the Shared Decision-Making Collaborative of the Duncan Family Institute for Cancer Prevention and Risk Assessment at the University of Texas MD Anderson Cancer Center.

  • Competing interests KRS receives salary support as a scientific advisory board member for the Informed Medical Decisions Foundation, now part of Healthwise, a not-for-profit organisation that develops patient decision aids. VS received personal fees from Merck Pharmaceuticals. During the last 36 months, SS has received funding from the Agency for Health Services Research and Quality for a scoping review to identify a research agenda on shared decision making and high value care. During this time, she also completed unfunded research or papers on patient decision aid evaluations and developed the Reaching for High Value Care toolkit, a toolkit of evidence briefs and resources on patient-centred high value care for all levels of system leaders. As part of those efforts and efforts on the current manuscripts, SS has developed a series of research resources on reporting research. She is considering the potential benefits and harms of pursuing intellectual property protection for some of these efforts, but has not initiated these to date.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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