Advancing in shared decision making: asymptomatic carotid stenosis

In the last decades there has been a paradigm change in the doctor-patient relationship, from a paternalistic model to a patient centered medicine. Shared decision making (SDM) is a process that involves bidirectional communication between physicians and patients about the illness, different treatment options, and, through the deliberation process, reaching an agreement in the ultimate decision made. Various different tools have been developed to promote shared decision making, through different types of support methods (leaflets, books, videos, websites or other interactive media), frequently using visual aids like smiley faces plots or other pictograms. Our Working Group would like to join this evolutionary process. Thus, we have developed a visual aid tool to help in the decision-making process in the case of asymptomatic carotid stenosis > 70%. We have based on Cates plots that help to quantify risks and benefits of specific interventions in a standardized manner.