Dunja Dreesens

71 email (see annex B). All participants took part in the iterative discussions by email afterwards to finalise the manuscript with the draft framework. Step 1 was to select the tool types to be used when building the framework. Inclusion criteria were: - Main target group are patients (family, care givers); - Content driven instead of process oriented; - Tool type globally known and used; - Fits within the definition of the patient-directed knowledge tool. Based on the outcomes of the subgroups and decisions on these with all participants, we excluded seven tool types (not aimed directly at the patient) from the original list of 11 and added one tool perceived to be aimed at the patient directly but not on the list provided (see Table 2). While discussing the selection with the whole group, we decided to split PDAs into an encounter patient decision aid (ePDA) and an ‘independent’ PDA, leading to six tools. This distinction is important because the patients will use the former while talking with a healthcare professional and the latter independently, pre- or post-encounter. Tools such as action plans and decision guides were excluded because they concentrate on ‘how’ (process), and less on ‘what’ (knowledge). Decision coaching tools were deemed out of scope as well because these are aimed at the patient’s coach, rather than primarily at the patient. During the telephone conference two tool types – question prompt list and decision box – were added because they support involving the patient in the care process, leading to a total of eight tools (see Table 2 and Annexes F and D). Table 2: overview of preliminary included and excluded tool types during face-to-face meeting and teleconference # TOOL TYPE INCLUDED, EXCLUDED AND REMARKS 1 Decision tree Preliminary included from list during face-to-face meeting 2 Summary of clinical practice guideline Preliminary included from list during face-to-face meeting Patient decision aid (PDA), split into: Preliminary included from list during face-to-face meeting 3 - Encounter patient decision aid (ePDA) 4 - Independent patient decision aid (PDA) 5 Patient information Preliminary included during face-to-face meeting 6 Care map Added during face-to-face meeting and preliminary included 7 Decision box Added during teleconference and preliminary included 8 Question prompt list Added during teleconference and preliminary included Action plan Added during face-to-face meeting, excluded Decision guide Added during face-to-face meeting, excluded Care pathway Excluded from list Quality standard Excluded from list Care standard Excluded from list Care module Excluded from list Clinical practice guideline Excluded from list Chapter 4