Page - 119 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

3. Discussion In this section, we reflect on the value of the boosting framework in the context of personal health choices and SDM and on the maturity of the boosting framework in this context. Generally speaking, the use of theory and frameworks in the design and evaluation of health informatics interventions aimed at supporting health choices and SDM comes with certain advantages compared to building health informatics interventions based on common sense. First, theories and frameworks are more consistent with the state-of-the art scientific knowledge and facts, in this case mainly from the field of decision-making psychology, than common sense. This makes theory-based design more likely to result in effective interventions. Moreover, a theoretical framework, such as the boosting framework, can be developed into a more explicit process theory tailored to the field of personal health choices and SDM, from which testable assumptions can be derived. By empirically testing these assumptions, the theory matures, with adaptions based on empirical findings where necessary, which can in turn yield new testable assumptions. Currently, the boosting framework does not yet provide a full-blown process model with detailed “how-to” information describing how research evidence can be translated into practical health informatics solutions. Rather, we believe the boosting framework helps to explicate some guiding principles for future research, from which testable assumptions can be derived. To find the most promising avenues for future research, we should start with the end in mind and stay focused on the ultimate aim: Helping patients and caregivers to make well-informed medical decisions that align with what matters most from the patient’s personal perspective [31]. Table 1 provides some examples to illustrate the potential of the boosting framework in the SDM context. Table 1. Health Informatics in SDM: Guiding principles and testable assumptions derived from the boosting framework. Guiding Principle Testable Assumptions Empirical Evidence Competences can help people make better decisions; boosts can exist of making information easier to understand; or training (more difficult) skills (1) Presenting risk information in natural frequencies improves understanding (2) Adding illustrations, animations and videos to text-based information improves understanding (3) Training social skills will smoothen interaction between patient and health care provider Partly available Decisions based on acquired competences increase people’s autonomy (1) Decisions based on boosts increase autonomy (2) More adherence to patient preferences, (3) More well-being (specifically in the long run) More research needed Competences can be used across different patient populations, situations and time (1) People can acquire decision-making competences relevant to SDM through formal education (2) Healthcare providers can acquire generic SDM competences in professional education More research needed M.deVriesetal. /FosteringSharedDecisionMakingwithHealth Informatics Interventions 119