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Shared decision-making is an approach in which:

 Both clinician and patient bring their respective expertise to the clinical issue upon which a decision is to be made

 Patient autonomy is respected

 Patient engagement in the decision-making process is promoted

 The decision is reached with reference to reliable research-evidence.

While SDM intends to be based on research evidence, in practice several factors can result in drift from published guidelines and recommendations, rendering decisions less effective, for example when moving a patient between steps of care (Delgadillo et al., 2015).