Decision Aids

A decision aid (DA) is an intervention that provides information on the clinical options and outcomes relevant to the person’s health. It is designed to help people make specific choices about different options for their health care by providing information on the clinical options and outcomes relevant to the person’s health. Decision aids are explicit about choices and encourage consumers to express their preference in clinical situations when there are different options. Decision aids are unbiased and non-directive and aim to support an informed choice consistent with healthcare values and preferences which may be acted on. They are designed to be adjuncts to the patient-physician interaction. Decision aids have received much support in the literature. A Cochrane Review the impact of Decision Aids has recently been updated and is now available (O’Connor et al 2003).

Cancer Screening Decision Aids

1. A decision aid for women aged 40 thinking about starting mammography screening
Some 40 year old women start thinking about whether they should attend mammography screening now or wait until they are 50. If you are in this situation, you might find this website helpful www.mammogram.med.usyd.edu.au/

2. Choosing whether to continue or stop mammography screening at 70
Women who have gone for mammography screening in recent years and who are now approaching 70 years of age are advised to consider both benefits and harms of continuing to be screened. But doing this may be difficult for individual women. This decision aid has been developed to help women make this decision using the best available evidence.

The decision aid has been evaluated in a randomized controlled trial, conducted jointly by researchers at the University of Sydney and BreastScreen NSW. The trial found that women who used the decision aid were better informed and more were able to make an informed choice (73.5% vs 48.8%, p<0.0001) about whether to continue or stop screening. The decision aid did not increase anxiety. To our knowledge this is the first trial of a mammography screening decision aid in the world.

For further information:
A decision aid for women aged 70 and older at their next screening mammogram (pdf)
Knowledge questions used to evaluate the Decision Aid (pdf)

3. A decision aid for women with a mildly abnormal Pap smear (pdf)

4. Making decisions: Should I have a screening test for bowel cancer? (pdf)

5. Making decisions: Choices for men aged 55-64 years:Should you have a test to screen for bowel cancer? (pdf)

6. Making decisions: Choices for women aged 55-64 years:Should you have a test to screen for bowel cancer? (pdf)

Women's Health

1. Making decisions: Should I use hormone replacement therapy? (pdf)

2. Understanding ductal carcinoma in situ (DCIS) and deciding about treatment (pdf)

3. Recovering after radiation therapy: A guide for women (pdf)
This psycho-educational booklet has been developed to facilitate psycho-sexual adjustment of women undergoing pelvic radiotherapy for gynaecological or anorectal cancer. It provides evidence-based information about radiation-induced side effects potentially affecting post-treatment sexual functioning, and rehabilitation options and evidence-based self-care strategies, such as the use of vaginal dilators, to prevent/minimise vaginal changes.

Pregnancy Decision Aids

1. A decision aid for pregnant woman with a breech baby

This decision aid is for pregnant women who have a baby in a breech position (bottom rather than head first), are around 36-37 weeks pregnant and who haven’t had a caesarean section before. There is good information from high quality medical research studies about the options for women with a breech presentation in late pregnancy. These include the option of turning a breech baby to a head down position using external cephalic (pronounced ke-falic) version, called ECV for short, or planned caesarean section. Each of these options has benefits and risks, and the importance of these varies for each woman depending on her own personal values and preferences.

This decision aid has been developed to help women make this decision using the best available medical evidence. It presents the pros and cons for each of the options and helps women weigh up the options that are best for their situation. The decision aid is not meant to replace your usual pregnancy care but to help prepare you for an informed discussion with your doctor or midwife so you can decide together about the best option for you and your breech baby.

INSTRUCTIONS – To get the most out of this information please use the audio and the pdf together.

  • Should I have my breech baby turned? (pdf)
  • Should I have my breech baby turned? (audio)


2. A decision aid for women having their first baby and considering their choices for labour pain relief

There are many choices for labour and childbirth pain relief and there are also a wide variety of sources of information regarding the risks and benefits. Often these sources are based on personal experience rather than good scientific knowledge. In this decision aid we have carefully examined only the highest quality research evidence and have presented it in a way that will help you to make a decision regarding what labour pain relief will suit you. Please use both the booklet and the worksheet together as these will help you decide what options you prefer. This decision aid has been tested in a randomised controlled trial with almost 600 women by researchers at the University of Sydney and has been shown to improve knowledge without increasing anxiety (p=0.01).

This is ideally used for women having their first baby as often the choices and or birth you had in your previous pregnancies will impact on the choices you have for subsequent pregnancies. Furthermore you should keep an open mind as labour and childbirth can be unpredictable. Finally you may like to discuss your decisions with your care-providers and with your birth partner(s).

PRINT INSTRUCTIONS - Please note that the versions for printing should be printed double-sided and flipped on the short edge as a booklet to be viewed properly.

  • Labour Pain Decision Aid (ON SCREEN READING VERSION) (doc)
  • Decision Aid for labour pain relief (PRINT version) (pdf)
  • Worksheet to accompany the labour pain relief decision aid (PRINT version) (pdf)

Child Health

1. The MMR Decision Aid: Are you considering MMR vaccination for your child? Would you like more information? (pdf)

Clinical Trial Participation Decision Aids

Making Choices: Deciding whether to join the IBIS-II Prevention study (PDF)

Deciding whether to join the IBIS-II DCIS study: A Decision Aid for Women with DCIS (PDF)

Making Choices: A Decision Aid for Women with Breast Cancer. Deciding whether to join the SNAC2 trial (PDF)

Cancer Treatment Decision Aids

A decision aid for women considering further chemotherapy for refractory or resistant ovarian cancer (PDF)

Recovering after radiation therapy: A guide for women (PDF)