Dunja Dreesens

35 independently from the guideline – but as an integral part of the guideline. By contrast, the Nurses Association does regard a summary (sheet) of the guideline as a tool that can be used independently. Patient versions of guidelines were mostly viewed as tools to be used independently. With other tools, however, links were expected, as they cover the same subject and are probably based on the same knowledge. For example, CPGs and patient decision aids developed by the Dutch Institute for Healthcare Improvement were not always developed in concordance with each other, as the CPG for a specific subject was updated but the corresponding decision aid was not. Figure 3 provides a rendering of how different tool types in our view could be (inter)connected or related to each other. Figure 3: A rendering of how tool types could be (inter)connected or related to each other Abbreviations figure 3 - QRG: quick reference guide - CPG: clinical practise guideline Discussion The aim of the review was to assess the number of tool types available to clinicians or patients, by identifying the existing national-level tools that support knowledge translation and (shared) decision-making. We included 67 tools published by 20 organisations. So, does the real-life situation correspond to the picture of chaos painted in the introduction, with doctors bogged down in a myriad of tools? Notwithstanding the fact that the review only included tools from a limited number of national organisations that develop and disseminate knowledge tools, we suggest that the answer is yes. There is an abundance of tool types available and the definitions of these tools are mostly vague or incomplete. This made it difficult to assess whether these tools differ in terms of content or purpose. Chapter 2