Combining deliberation and intuition in patient decision support

Objective: To review the strengths and weaknesses of deliberative and intuitive processes in the context of patient decision support and to discuss implications for decision aid (DA) design. Methods: Conceptual review of the strengths and weaknesses of intuitive and analytical decision making and applying these findings to the practice of DA design. Results: DAs combine several important goals: providing information, helping to clarify treatment related values, supporting preference construction processes, and facilitating more active engagement in decision making. Many DAs encourage patients to approach a decision analytically, without solid theoretical or empirical grounding for this approach. Existing research in other domains suggests that both intuition and deliberation may support decision making. We discuss implications for patient decision support and challenge researchers to determine when combining these processes leads to better outcomes. Conclusions: Intuitive and analytical decision processes may have complementary effects in achieving the desired outcomes of patient decision support. Practice implications: DA developers should be aware that tools solely targeted at supporting deliberation may limit DA effectiveness and harm preference construction processes. Patients may be better served by combined strategies that draw on the strengths and minimize the weaknesses of both deliberative and intuitive processes. (c) 2012 Elsevier Ireland Ltd. All rights reserved.