Open Access Open Access  Restricted Access Subscription Access

Fast and frugal tools for shared decision-making: how to develop Option Grids

Katy Marrin, Katherine Brain, Marie-Anne Durand, Adrian Edwards, Amy Lloyd, Victoria Thomas, Glyn Elwyn


Option Grids provide a fast and frugal approach to supporting shared decision-making, providing a promising solution to the implementation gap experienced by longer decision aids. On one page they present evidence-based summaries of the available condition-specific treatment options, alongside patients’ frequently asked questions, helping patients to discuss the key features, risks and benefits of treatment options in relation to their personal values and preferences. They are designed to be sufficiently brief enough for use in clinical encounters and accessible enough to support a better dialogue between patients and clinicians. The Option Grid Collaborative was formed in 2009 and operates on a not-for-profit basis  to manage the development process as well as provide support to around 65 multi-disciplinary stakeholders currently involved in developing Option Grids. The Option Grid website ( hosts 13 Option Grids and there are a further 25 Option Grids in development as of September 2012. This paper provides guidance for individuals or teams who are interested in facilitating shared decision-making using short tools on how to develop an Option Grid.

Full Text:



Elwyn, G., Lloyd, A., Joseph-Williams, N., Cording, E., Thomson, R., Durand, M.A. & Edwards, A. (2012). Option Grids: Shared decision making made easier. Patient Education and Counseling doi: 10.1016/j.pec.2012.06.036.

Department of Health. (2010). Equity and excellence: Liberating the NHS. London.

Patient Protection and Affordable Care Act, Pub. L. No. 111-148 (23rd March 2010, 2010).

Elwyn, G., Tilbert, J. & Montori, V. (2012). The ethical imperative for shared decision making. Paper in preparation.

Coulter, A., Edwards, A., Elwyn, G. & Thomson, R. (2011). Implementing shared decision making in the UK. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 4 (105) 300-304.

Stacey, D., Bennett, C.L., Barry, M.J., Col, N.F., Eden, K.B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Légaré, F. & Thomson, R. (2011). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews (10) CD001431.

Elwyn, G., Laitner, S., Coulter, A., Walker, E., Watson, P. & Thomson, R. (2010). Implementing shared decision making in the NHS. British Medical Journal 341, c5146.

Thomson, R., Murtagh, M., Khaw, F.M. (2005). Tensions in public health policy: patient engagement, evidence-based public health and health inequalities. Quality and Safety in Health Care14 (6) 398-400.

Gravel, K., Légaré, F. & Graham, I.D. (2006). Barriers and facilitators to implementing shared decision-making in clinical practice: a systematic review of health professionals' perceptions. Implemention Science 1(1) 16.

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P. & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 82 (4) 581-629.

Robert, G., Greenhalgh, T., MacFarlane, F. & Peacock, R. (2010). Adopting and assimilating new non-pharmaceutical technologies into health care: a systematic review. Journal of Health Services Research & Policy 15 (4) 243-250.

Gravel, K. & Graham, I.D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals' perceptions. Patient Education and Counseling 73 (3) 526-535.

Gigerenzer, G. & Todd, P.M. (1999). Simple heuristics that make us smart. New York: Oxford University Press.

Sivell, S., Edwards, A., Elwyn, G. & Manstead, A.S.R. (2011). Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions? Health Expectations 14, 6-19.

Lloyd, A., Joseph-Williams, N., Beasley, A., Tomkinson, A. & Elwyn, G. (2012). Shared decision making in a multidisciplinary head and neck cancer team: a case study of developing Option Grids. International Journal of Person Centered Medicine. In press.

Health Foundation. (2012). MAGIC: Shared decision making. Available at: (last accessed 16th August 2012)

Elwyn, G., Frosch, D. & Rollnick, S. (2009). Dual equipoise shared decision making: definitions for decision and behaviour support interventions. Implementation Science 4 (1) 75.

Gigerenzer, G. & Edwards, A. (2003). Simple tools for understanding risks: from innumeracy to insight. British Medical Journal 327, 741-744.

Feldman-Stewart, D., Brennenstuhl, S., Brundage, M.D. & Roques, T. (2006). An explicit values clarification task: development and validation. Patient Education and Counseling 63 (3) 350-356.

Svenson, O. (1992). Differentiation and consolidation theory of human decision making: A frame of reference for the study of pre-and post-decision processes. Acta Psychologica Scandinavica 80 (1-3) 143-168.

National Institute for Health and Clinical Excellence. (2008). Surgical Management of Otitis Media with Effusion (OME). CG60. London: National Institute for Health and Clinical Excellence.

Gunning, R. (1952). The technique of clear writing. New York, NY: McGraw-Hill International Book Co.



  • There are currently no refbacks.