Glyn Elwyn
Biographic Data
| ID | 330077 |
|---|---|
| NAME | Glyn Elwyn |
| GIVEN NAMES | Glyn |
| FAMILY NAME | Elwyn |
| SIGNATURE | ELWYN G |
| AFFILIATIONS | Cardiff University |
| ORCID | 0000-0002-0917-6286 |
| VERIFIED | Yes |
| TOTAL WORKS | 58 |
| TOTAL CITATIONS | 73 |
| AUTHOR COUNT | 58 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1999 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 5 |
Deprescribing Psychiatric Medications in Youth
Translation and Psychometric Evaluation in Cancer Care of the German Version of collaboRate TM —a 3‐item Patient‐reported Measure of Shared Decision‐Making
Introduction The collaboRATE TM measure assesses the shared decision‐making process from patients' perspective with three items. Because of its shortness, it is especially feasible in routine care. It was developed in English and has been translated into several languages. This study aimed to translate collaboRATE into German, test its comprehensibility and evaluate its psychometric properties. Methods Translation followed the TRAPD protocol. Com…
Supporting the Individualized Use of Digital Tools in Community Mental Health
Clinician-Spoken Plain Language in Health Care Encounters
Documenting the digital divide
The transition to and acceptance of digital mental health tools has been heralded as a paradigm shift for providing and accessing care. Yet, providers and clients express concerns over privacy, efficacy, and personalization, as well as their ability to assess the thousands of available digital tools. In response to these concerns and calls for support to address them, the authors developed the Technology Specialist program. After a successful fea…
The impact of adding cost information to a conversation aid to support shared decision making about low‐risk prostate cancer treatment
BACKGROUND: Decision aids help patients consider the benefits and drawbacks of care options but rarely include cost information. We assessed the impact of a conversation-based decision aid containing information about low-risk prostate cancer management options and their relative costs. METHODS: We conducted a stepped-wedge cluster randomised trial in outpatient urology practices within a US-based academic medical center. We randomised five clini…
The Confident study protocol
NCT05168800 at ClinicalTrials.gov, registered December 23, 2021
The Costs of Implementing a Conversation Aid for Uterine Fibroids in Multiple Health Care Settings
BACKGROUND: Health care organizations considering adopting a conversation aid (CA), a type of patient decision aid innovation, need information about the costs of implementation. OBJECTIVES: The aims of this study were to: (1) calculate the costs of introducing a CA in a study of supported implementation in 5 gynecologic settings that manage individuals diagnosed with uterine fibroids and (2) estimate the potential costs of future clinical implem…
Processes for evidence summarization for patient decision aids
BACKGROUND: Patient decision aids (PDAs) should provide evidence-based information so patients can make informed decisions. Yet, PDA developers do not have an agreed-upon process to select, synthesize and present evidence in PDAs. OBJECTIVE: To reach the consensus on an evidence summarization process for PDAs. DESIGN: A two-round modified Delphi survey. SETTING AND PARTICIPANTS: A group of international experts in PDA development invited develope…
The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment
OBJECTIVE: To investigate the association between patients' preferred treatment and eventual treatment. Second, to compare patients with surgical treatment to watchful waiting in order to identify predictive factors for surgery. METHODS: A single-centre retrospective study was performed between December 2015 and August 2018. Patients (≥18 years) who used a patient decision aid (PDA) for gallstones or inguinal hernia were included. After their fir…
Can Consent to Participate in Clinical Research Involve Shared Decision Making
Shared decision making honors patient autonomy and improves patient comprehension and therefore should be a part of every clinical decision a patient makes. Use of shared decision making in research informed consent conversations is more complicated due to diverse and potentially divergent investigator and patient interests, along with the presence of clinical equipoise. This article clarifies these different interests and discusses ways in which…
Sliding-Scale Shared Decision Making for Patients With Reduced Capacity
Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions. Shared decision making can be challenging, however, when patients have impaired decision-making capacity. Here, after presenting an illustrative case example, this paper proposes a capacity-adjusted "sliding scale" approach to shared decision making
Promoting or Undermining Quality Decision Making? A Qualitative Content Analysis of Patient Decision Aids Comparing Surgical and Medication Abortion
A three‐goal model for patients with multimorbidity
BACKGROUND: To meet the challenge of multimorbidity in decision making, a switch from a disease-oriented to a goal-oriented approach could be beneficial for patients and clinicians. More insight about the concept and the implementation of this approach in clinical practice is needed. OBJECTIVE: This study aimed to develop conceptual descriptions of goal-oriented care by examining the perspectives of general practitioners (GPs) and clinical geriat…
Quantity over quality—Findings from a systematic review and environmental scan of patient decision aids on early abortion methods
Using Collabo Rate , a brief patient‐reported measure of shared decision making
INTRODUCTION: CollaboRATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate CollaboRATE scores and response rates across multiple clinical settings with varied patient populations. METHOD: All adult patients at three United States primary care practices were eligible to complete CollaboRATE post-visit. To i…
What matters most
NCT03136367 at ClinicalTrials.gov Protocol version: Manuscript based on study protocol version 2.2, 7 November 2017
Patients’ views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters
BACKGROUND: are a type of decision support tool specifically designed to be used during clinical encounters. OBJECTIVE: To explore patients' views of the Option Grid encounter tool used in clinical consultations with physiotherapists, in comparison with usual care, within a patient population who are likely to be disadvantaged by age and low health literacy. METHODS: Semi-structured interviews with 72 patients (36 who had been given an Option Gri…
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters
BACKGROUND: Are the benefits of recording clinical encounters shared across different groups, or do they vary based on social position? Studies show that educated patients record their clinical visits to enhance their experience, but very little is known about recording benefits among "hard-to-reach" populations. OBJECTIVE: To examine the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either…
Pathways and prospects in cancer research
Supporting Shared Decision-making for Children’s Complex Behavioral Problems
Measurement challenges in shared decision making
Measuring clinicians' shared decision‐making ( SDM ) performance is a key requirement given the intensity of policy interest in many developed countries – yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this V iewpoint A rticle, we investigate the development of existing patient‐reported measures ( PRM s) of SDM identified in a recent review. We find that patients were involved in t…
Doctors’ perspectives of informed consent for non‐emergency surgical procedures
BACKGROUND: The need to involve patients more in decisions about their care, the ethical imperative and concerns about ligation and complaints has highlighted the issue of informed consent and how it is obtained. In order for a patient to make an informed decision about their treatment, they need appropriate discussion of the risks and benefits of the treatment. OBJECTIVES: To explore doctors' perspectives of gaining informed consent for routine …
Assessments of the extent to which health‐care providers involve patients in decision making
Developing IntegRate
This new measure, IntegRATE, represents a patient-reported measure of integration in health care delivery that is conducive to use in both routine performance monitoring and research. The psychometric properties of the measure will be assessed in the next stage of development
When is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter
Snapshots and snippets
Technology identity
Of the edgelands”
In an editorial in a previous issue of this journal Rapport et al introduced the metaphor of the edgelands, arguing that the area between urban and rural landscapes serves to illustrate some of the difficulties of interdisciplinarity experienced by those who work in the medical humanities. In this paper the authors explore some specific issues of qualitative research methodology in health care research. The paper describes a broadening out of the…
The Role of Action Research in the Investigation and Diffusion of Innovations in Health Care
In this article, the authors discuss the role of action research in relation to the investigation and practical implementation of innovations in health care. The diffusion of innovations is an essential component of the modernization of health services worldwide. However, the literature shows that it is not an easy process to research. A paradox is noted that although action research has much to offer, it has had only a limited impact in the inno…
Developing IntegRate
This new measure, IntegRATE, represents a patient-reported measure of integration in health care delivery that is conducive to use in both routine performance monitoring and research. The psychometric properties of the measure will be assessed in the next stage of development
From manila to monitor
This article presents a study that explores how general practitioners (GPs) reflect on their workspaces and what that tells us about how professional practice is enacted. The study employed biography as its data collection method to enable three pilot and nine other GPs from the Swansea Region in the UK to write about their consulting rooms. Thematic analysis of biographies, employing individual and group analysis sessions, revealed eleven themes…
The view from the edgelands
Medical humanities is characterised as occupying the “edgelands” between science and the humanities In a discussion of the built landscape, Shoard has coined the expression “the edgelands” to describe that interesting area to be found on the outskirts of towns, between rural and urban areas. This area is: “an interfacial rim...characterised by rubbish tips and warehouses, superstores and derelict industrial plant, office parks and gypsy encampmen…
Is ‘shared decision‐making’ feasible in consultations for upper respiratory tract infections? Assessing the influence of antibiotic expectations using discourse analysis
OBJECTIVES: To examine the discourse of consultations in which conflict occurs between parents and clinicians about the necessity of antibiotics to treat an upper respiratory tract infection. To appraise the feasibility of shared decision-making in such consultations. DESIGN: A qualitative study using discourse analysis techniques. SETTING: A general practice with 12 500 patients in an urban area of Cardiff, Wales. PARTICIPANTS: Two consultations…
When is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter
Consumers’ views of quality in the consultation and their relevance to ‘shared decision‐making’ approaches
Background There is a recognized need to assess the effects of shared decision‐making and other communication interventions. However, the outcomes usually assessed for evidence of ‘effectiveness’ are determined by researchers and have not been based on consumers’ views. Aim This study aimed to identify the important outcomes of consultations for consumers, and to compare with those reported in the current literature. Setting and participants Fort…
The problematic of decision‐sharing
Shared decision‐making is increasingly advocated as a means of interacting with patients but there is also a widely accepted view that many factors will militate against this ideal. While some patients may not wish to take on the responsibility of decision‐making, it is also evident that many find it difficult to assimilate probabilities about future events and overestimate the likelihood of some outcomes, especially when terms such as ‘stroke’, …
Evolving the multiple roles of ‘patients’ in health‐care research
Objective This paper offers ‘consumer‐led’ reflections by steering group members of a patient‐centred research study involving consumer advocates, patients’ associations and patients, throughout the whole study, from pre‐ to post‐study phases. Original Study Design The study: ‘Shared decision making and risk communication in general practice’ incorporated systematic reviews, psychometric evaluation of outcome measures, and quantitative, qualitati…
Exploring doctor and patient views about risk communication and shared decision‐making in the consultation
Background There have been significant conceptual developments regarding shared decision‐making (SDM) and assessments of people's hypothetical preferences for involvement in treatment or care decisions. There are few data on the perceptions of patients and professionals about SDM in actual practice. Objective To explore, from paired doctor–patient interviews, participants’ perceptions of SDM in the consultation and the level of consensus between …
The view from the edgelands
Medical humanities is characterised as occupying the “edgelands” between science and the humanities In a discussion of the built landscape, Shoard has coined the expression “the edgelands” to describe that interesting area to be found on the outskirts of towns, between rural and urban areas. This area is: “an interfacial rim...characterised by rubbish tips and warehouses, superstores and derelict industrial plant, office parks and gypsy encampmen…
The Option scale
Objective To examine the psychometric properties of a revised scale, named ‘observing patient involvement in decision making’ (OPTION), by analysing its reapplication to a sample of routine primary care consultations. The OPTION instrument assesses to what degree clinicians involve patients in decision making. Design Cross‐sectional assessment of medical interaction by two calibrated raters. Setting Primary care. Participants Twenty‐one general p…
Of the edgelands”
In an editorial in a previous issue of this journal Rapport et al introduced the metaphor of the edgelands, arguing that the area between urban and rural landscapes serves to illustrate some of the difficulties of interdisciplinarity experienced by those who work in the medical humanities. In this paper the authors explore some specific issues of qualitative research methodology in health care research. The paper describes a broadening out of the…
Developing a quality criteria framework for patient decision aids
OBJECTIVE: To develop a set of quality criteria for patient decision support technologies (decision aids). DESIGN AND SETTING: Two stage web based Delphi process using online rating process to enable international collaboration. PARTICIPANTS: Individuals from four stakeholder groups (researchers, practitioners, patients, policy makers) representing 14 countries reviewed evidence summaries and rated the importance of 80 criteria in 12 quality doma…
Decision aids for familial breast cancer
Background There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex choices. Objective Exploration of users’ views and reactions to three decision aids for genetic testing for breast cancer using focus groups. Setting A…
Development of an information source for patients and the public about general practice services
Objective The publication of information about the performance of health‐care providers is regarded as central to promoting greater accountability and empowering patients to exercise choice. The evidence suggests that the public is not very interested in accessing or using current sources of information. This study aimed to explore the information needs of patients in the context of UK primary care and to develop an information source about gener…
Snapshots and snippets
From manila to monitor
This article presents a study that explores how general practitioners (GPs) reflect on their workspaces and what that tells us about how professional practice is enacted. The study employed biography as its data collection method to enable three pilot and nine other GPs from the Swansea Region in the UK to write about their consulting rooms. Thematic analysis of biographies, employing individual and group analysis sessions, revealed eleven themes…
The Role of Action Research in the Investigation and Diffusion of Innovations in Health Care
In this article, the authors discuss the role of action research in relation to the investigation and practical implementation of innovations in health care. The diffusion of innovations is an essential component of the modernization of health services worldwide. However, the literature shows that it is not an easy process to research. A paradox is noted that although action research has much to offer, it has had only a limited impact in the inno…
Development of a theory of implementation and integration
BACKGROUND: Theories are important tools in the social and natural sciences. The methods by which they are derived are rarely described and discussed. Normalization Process Theory explains how new technologies, ways of acting, and ways of working become routinely embedded in everyday practice, and has applications in the study of implementation processes. This paper describes the process by which it was built. METHODS: Between 1998 and 2008, we d…
Shared Decisionmaking In Health Care Achieving Evidencebased Patient Choice
Implementing shared decision making in the NHS
BACKGROUND AND PURPOSE: During thyroidectomy incomplete resection of the thyroid gland may occur. This complicates the imaging surveillance of these patients as residual thyroid needs to be distinguished from local recurrence. Therefore, the purpose of this study was to determine if multiphasic multi-detector computed tomography (4D-MDCT) can differentiate residual nonmalignant thyroid tissue and recurrent thyroid carcinoma after thyroidectomy. M…
Deliberation before determination
Objectives In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post‐hoc estimations and post‐decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. Background There has been a steady …
Information and decision support needs of parents considering amniocentesis
Objective Our aim was to clarify and categorize information and decision support needs of pregnant women deciding about amniocentesis. Background Prenatal screening for Down’s syndrome (implemented in routine practice) generates a quantifiable risk of chromosome abnormality. To increase certainty, chromosomal material needs to be obtained through amniocentesis or other diagnostic test. Amniocentesis carries risks of pregnancy loss. Methods Semi‐s…
Approaches to reducing the most important patient errors in primary health-care
We have previously reported a preliminary taxonomy of patient error. However, approaches to managing patients' contribution to error have received little attention in the literature. This paper aims to assess how patients and primary care professionals perceive the relative importance of different patient errors as a threat to patient safety. It also attempts to suggest what these groups believe may be done to reduce the errors, and how. It addre…
Clinicians’ concerns about decision support interventions for patients facing breast cancer surgery options
BACKGROUND: There is interest in interventions that provide support for patients facing challenging decisions, such as the choice between mastectomy and breast conservation surgery for breast cancer. However, it is difficult to implement these interventions. One potential source of resistance is the attitudes of clinicians. OBJECTIVE: To examine specialist breast clinicians' opinions about the provision of decision support interventions (DesIs) f…
Understanding surgery choices for breast cancer
Objective To describe the evidence about factors influencing breast cancer patients’ surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). Background A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservati…
The importance and complexity of regret in the measurement of ‘good’ decisions
Communicating uncertainty can lead to less decision satisfaction
BACKGROUND: Given the large number of interventions of uncertain effectiveness, research on communicating uncertainty is needed to examine its impact on patients' health decisions. OBJECTIVE: To examine physicians' communication of uncertainty and its impact on patients' decisions and decision satisfaction. DESIGN, SETTING, AND PARTICIPANTS: Participants included female patients seen in a breast health centre whose physicians were discussing a de…
Medicine (39 works) · Patient-Provider Communication in Healthcare (35 works) · Psychology (35 works) · Computer Science (32 works) · Nursing (24 works) · Political science (17 works) · Alternative medicine (16 works) · Family medicine (14 works) · Sociology (14 works) · Health care (13 works)