Centre for Evidence-Informed Health Decisions

Our goals

The Centre for Evidence-Informed Health Decisions is primarily focussed on conducting research that helps people to make informed decisions about health – including health professionals, patients, and the public. The research aimed at health professionals includes developing and evaluating strategies and tools to increase the awareness and usability of evidence about interventions and skills for incorporating this into conversations with patients.

The Centre’s interdisciplinary research draws upon the areas of evidence-based practice, shared decision making, health communication, knowledge translation, and public health.

The Centre also conducts workshops in evidence-based practice and shared decision making. This training is directed at health professionals and health professional students of all disciplines. The Centre also leads research about the teaching of these skills. A 4th edition of the widely used "Evidence-Based Practice: Across the Health Professions" text has been published in 2023.

The Centre co-ordinates the Australian Shared Decision Making Network. If you're interested in joining the network, please email the SDM Network Chair - Professor Tammy Hoffmann.

Projects

The role of expectations about intervention benefits and harms in health decision making

Sharma S, Traeger AC, Reed B, Hamilton M, O’Connor DA, Hoffmann TC, Bonner C, Buchbinder R, Maher CG. Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis. BMJ open. 2020; 10(8):e037820.
Ewald B, Del Mar C, Hoffmann T. Quantifying the benefits and harms of various preventive health activities. Australian Journal of General Practice. 2018; 47(12):842-5.
Traeger AC, Reed BJ, O’Connor DA, Hoffmann TC, Machado GC, Bonner C, Maher CG, Buchbinder R. Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis. BMJ open. 2018; 8(2):e019470.
Coxeter PD, Del Mar C, Hoffmann TC. Parents’ expectations and experiences of antibiotics for acute respiratory infections in primary care. The Annals of Family Medicine. 2017; 15(2):149-54.
Hoffmann, T., & Del Mar, C. Clinicians’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Internal Medicine, 2017; 177:407-19.
Hoffmann, T., & Del Mar, C. Patients’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Internal Medicine, 2015; 175(2):274-86.
Hoffman TC, Del Mar C. Great expectations: Our naïve optimism about medical care. The Conversation: Academic Rigor, Journalistic Flair, December. 2014; 22. Available from: theconversation.com/great-e
Hoffmann TC, Del Mar CB, Strong J, Mai J. Patients’ expectations of acute low back pain management: implications for evidence uptake. BMC Family Practice. 2013; 14(1):1-6.

The natural history and prognosis of conditions and the role of this evidence in informed decision-making

Abukmail E, Bakhit M, Hoffmann TC. Exploring individuals’ perceptions and acceptability of a ‘wait and see’approach for managing self-limiting illnesses: A qualitative study. Patient Education and Counseling. 2024;118:108032.
Boaitey KP, Hoffmann T, Baillie E, Bakhit M. Exploring general practitioners’ perception of the value of natural history information and their awareness and use of guidelines’ resources to support antibiotic prescribing for self-limiting infections: a qualitative study in Australian general practice. Australian Journal of Primary Health. 2023.
Abukmail E, Bakhit M, Jones M, Del Mar C, Hoffmann T. Effect of different visual presentations on the public’s comprehension of prognostic information using acute and chronic condition scenarios: two online randomised controlled trials. BMJ open. 2023; 13(6):e067624.
Boaitey KP, Bakhit M, Krzyzaniak N, Hoffmann TC. Information about the natural history of acute infections commonly seen in primary care: a systematic review of clinical practice guidelines. BMC Infectious Diseases. 2022; 22(1):897.
Hoffmann TC, Beckhaus J, Del Mar C. What happens if I do nothing?” A systematic analysis of the inclusion and quantitative description of a ‘no active intervention’ option in patient decision aids. Journal of General Internal Medicine. 2021; 36: 3897–3899.
Hoffmann T, Peiris R, Glasziou P, Cleo G, Del Mar C. Natural history of non-bullous impetigo: A systematic review of time to resolution or improvement without antibiotic treatment. British Journal of General Practice. 2021; 71(704):e237-242.
Hoffmann TC, Bakhit M, Del Mar C. Uncomplicated urinary tract infection in women. BMJ. 2021; 372:n725.
Abukmail E, Bakhit M, Del Mar C, Hoffmann T. Effect of different visual presentations on the comprehension of prognostic information: a systematic review. BMC Medical Informatics and Decision Making. 2021; 21, 249.
Hoffmann T, Peiris R, Del Mar C, Cleo G, Glasziou P. Natural history of uncomplicated urinary tract infection without antibiotics: a systematic review. British Journal of General Practice. 2020; 70(699):e714-22.

Shared decision making - current state and the need to increase its uptake

Hoffmann T, Bakhit M, Michaleff Z. Shared decision making and physical therapy: What, when, how, and why?. Brazilian Journal of Physical Therapy. 2022; 26(1):100382.
Tracey M, Thompson R, Muscat DM, Bonner C, Hoffmann T, McCaffery K, Shepherd HL. Implementing shared decision making in Australia. Z Evid Fortbild Qual Gesundhwes. 2022; 171:15-21.
González-González AI, Schmucker C, Nothacker J, Nury E, Dinh TS, Brueckle MS, Blom JW, van den Akker M, Röttger K, Wegwarth O, Hoffmann T, Gerlach FM, Straus SE, Meerpohl JJ, Muth C. End-of-life care preferences of older patients with multimorbidity: a mixed methods systematic review. J Clin Med. 2021; 10(1):91.
Hoffmann T, Gibson E, Barnett C, Maher C. Shared decision making in Australian physiotherapy practice: A survey of knowledge, attitudes, and self-reported use. PloS one. 2021; 16(5):e0251347.
Lewis J, Cook C, Hoffmann T, O’Sullivan P. The elephant in the room: too much medicine in musculoskeletal practice. Journal of Orthopaedic & Sports Physical Therapy. 2020; 50: 1-4.
Hoffmann T, Del Mar C, Santhirapala R, Freeman A. Teaching clinicians shared decision making and risk communication online: an evaluation study. BMJ Evidence-Based Medicine, 2020; 26(5):253
Hoffmann T, Lewis J, Maher C. Shared decision making should be an integral part of physiotherapy practice. Physiotherapy, 2020; 107:43-49.
Dimopoulos-Bick T, Osten, R, Shipway C, Trevena L, & Hoffmann T. Shared decision making implementation: a case study analysis to increase uptake in New South Wales. Australian Health Review, 2019; 43(5):492-9.
Shen HN, Lin CC, Hoffmann T, Tsai CY, Hou WH, Kuo KN. The relationship between health literacy and perceived shared decision making in patients with breast cancer. Patient education and counseling. 2019; 102(2):360-6.
Hoffmann T, Jansen J, Glasziou P. The importance and challenges of shared decision making in older people with multimorbidity. PLoS medicine. 2018; 15(3):e1002530.
Trevena, L., Shepherd H, Bonner C, Jansen J, Cust A, Leask J, Shadbolt N, Del Mar C, McCaffery K, Hoffmann T. Shared decision making in Australia in 2017. ZEFQ The Journal of Evidence and Quality in Healthcare. 2017; 123-124:17-20.
Hoffmann T, Straus S. Sharing knowledge for health care. JAMA Internal Medicine. 2017; 177(9):1243-4.
Hoffmann T, Glasziou P. Bringing shared decision making and evidence-based practice together. In Shared Decision Making in Health Care (3rd edition). 2016 Aug 4. Oxford: Oxford University Press.
Grant N, Rodger S, Hoffmann T. Intervention decision‐making processes and information preferences of parents of children with autism spectrum disorders. Child: care, health and development. 2016; 42(1):125-34.
Hoffmann T Del Mar C. Less is the new more: Choosing medical tests and treatments wisely. The Conversation 29 April 2015. Available from: theconversation.com/less-is-the-new-more-choosing-medical-tests-and-treatments-wisely-40756
Hoffmann T, Légaré F, Simmons M, Mc Namara K, McCaffery K, Trevena L, Hudson B, Glasziou P, Del Mar C. Shared decision making: what do clinicians need to know and why should they bother? MJA, 2014; 201:35-39.
Hoffmann T, Montori V, Del Mar C. The connection between evidence-based medicine and shared decision making. JAMA, 2014;312: 1295-6.
Del Mar CB, Glasziou PP, Hirst GH, Wright RG, Hoffmann TC. Should we screen for prostate cancer? A re-examination of the evidence. MJA. 2013; 198(10):525-7.

Enhancing the uptake of effective non-drug interventions

Albarqouni, L., Moynihan, R., Clark, J., Scott, A. M., Duggan, A., & Del Mar, C. (2021). Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review. BMC family practice, 22(1), 1-9.
Albarqouni, L., Sanders, S., Clark, J., Tikkinen, K. A., & Glasziou, P. (2021). Self-management for men with lower urinary tract symptoms: a systematic review and meta-analysis. The Annals of Family Medicine, 19(2), 157-167.
Hoffmann, T., Maher, C., Briffa, T., Sherrington, C., Bennell, K., Alison, J., Fiatarone Singh, M., & Glasziou, P. Prescribing exercise interventions for patients with chronic conditions. Canadian Medical Association Journal, 2016, 188 (7), 510-8.
Glasziou, P. Making non-drug interventions easier to find and use. Australian Family Physician, 2013, 42.
Hoffmann T, Glasziou P, Boutron I, Milne R, Perera R, Moher D, Altman D, Barbour V, Macdonald H, Johnston M, Lamb S, Dixon-Woods M, McCulloch P, Wyatt J, Chan A, & Michie S. Better reporting of interventions: The Template for Intervention Description and Replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.
Hayward KS, Churilov L, Dalton EJ, Brodtmann A, Campbell BCV, Copland D, Dancause N, Godecke E, Hoffmann TC, Lannin NA, McDonald MW, Corbett D, Bernhardt J. Advancing stroke recovery through improved articulation of non-pharmacological intervention dose. Stroke. 2021; 52:761–769
Sanders S, Gibson E, Glasziou P, Hoffmann T. Non-drug interventions for reducing SARS-CoV-2 transmission are frequently incompletely reported. Journal of Clinical Epidemiology. 2023; 157:102-109. doi: 10.1016/j.jclinepi.2023.02.006.
Hoffmann T, Bakhit M, Krzyzaniak N, Del Mar C, Scott A, Glasziou P. Soap versus sanitiser for preventing the transmission of acute respiratory infections in the community: a systematic review with meta-analysis and dose-response analysis. BMJ Open. 2021; 11:e046175. doi: 10.1136/bmjopen-2020-046175.
Abdel Shaheed C, Maher C G, Furmage A, Hoffmann T, McLachlan A J. Better measuring and reporting of adverse events are needed in back pain trials of non-drug interventions. BMJ. 2022; 377:o1055.
Eng J, Bird M, Godecke E, Hoffmann T, Laurin C, Olaoye O, Solomon J, Teasell R, Watkins C, Walker M. Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. International Journal of Stroke, 2019; 14:766-773. doi.org/10.1177/1747493019873597 (and co-published in Neurorehabilitation Neural Repair, 2019 Nov;33(11):935-942.)
Campbell M, Katikireddi S, Hoffmann T, Armstrong R, Waters E, & Craig P. TIDieR-PHP: a reporting guideline for population health and policy interventions, explanation and elaboration. BMJ. 2018; 361: k1079.
Hoffmann, T., Oxman, A., Ioannidis, J., Moher, D., Lasserson, T., Tovey, D., Stein, K., Sutcliffe, K., Ravaud, P., Altman, D., Perera, R., & Glasziou, P. Enhancing the usability of systematic reviews by improving the consideration and description of interventions. BMJ, 2017; 358: j2998.
Warner, M., Kelly, J., Reidlinger, D., Hoffmann, T., & Campbell, K. (2017). Reporting of telehealth-delivered dietary intervention trials in chronic disease. Journal of Medical Internet Research. 19(12):e410.
Abell, B., Glasziou, P., & Hoffmann, T. (2017). Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease. BMC Cardiovascular Disorders. 17(1):153.
Walker, M., Hoffmann, T., Brady, M., Dean, C., Eng, J., Farrin, A., Felix, C., Forster, A., Langhorne, P., Lynch, E., Radford, K., Stibrant-Sunnerhagen, K., & Watkins, C. (2017). Improving the development, monitoring, and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR). International Journal of Stroke. 12(5), 472-479.
Abell, B., Glasziou, P., & Hoffmann, T. (2017). The contribution of individual exercise training components to clinical outcomes in randomised controlled trials of cardiac rehabilitation: a systematic review and meta-regression. Sports Medicine Open. 3:19.
Walker, M., Hoffmann, T., Brady, M., Dean, C., Eng, J., Farrin, A., Felix, C., Forster, A., Langhorne, P., Lynch, E., Radford, K., Stibrant-Sunnerhagen, K., & Watkins, C. (2017). Improving the development, monitoring, and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabilitation Neural Repair. 31(10-11): 877–884.
Ludemann, A., Power, E., & Hoffmann, T. (2017). Investigating the adequacy of intervention descriptions in recent speech-language pathology literature – is evidence from randomised trials useable? American Journal of Speech-Language Pathology. 26, 443-455.
Sakzewski, L., & Hoffmann, T. (2016). Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy. Research in Developmental Disabilities. 59, 417-427.
Yamato, T., Maher, C., Saragiotto, B., Hoffmann, T., & Moseley, A. (2016). How completely are physiotherapy interventions described in reports of randomised trials? Physiotherapy. 102(2):121-6.
Abell, B., Glasziou, P., & Hoffmann, T. (2015). Reporting and replicating trials of exercise-based cardiac rehabilitation: do we know what the researchers actually did? Circulation: Cardiovascular Quality and Outcomes. 8: 187-194.
Hoffmann T, Erueti C, & Glasziou P. Poor description of non-pharmacological interventions: Analysis of consecutive sample of randomised trials. BMJ. 2013; 347: f3755.

Developing core competencies in the teaching of evidence-based practice

Albarquoni L, Glasziou P, Bakhit M, Del Mar C, Hoffmann T. Development of a contemporary evidence-based practice workshop for health professionals with a focus on pre-appraised evidence and shared decision-making: a before-after pilot study. BMJ Evidence-Based Medicine, 2020; 25:1-2.
Albarqouni, L., Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, Shaneyfelt T, Haynes RB, Guyatt G, Glasziou P. Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw Open. 2018; 1(2):e180281.
Albarqouni, L., Glasziou, P, Hoffmann T. Completeness of the reporting of evidence based practice educational interventions: a review. Medical Education. 2018; 52(2):161-170.

Helping the public and school students to think critically about health claims

Cusack L, Jones M, Desha L, Hoffmann TC.Teaching Australian high school students to think critically about health claims: a cluster randomized trial. Health Education Research. 2023; 38(5):412-25.
Cusack L, Del Mar CB, Chalmers I, Gibson E, Hoffmann TC. Educational interventions to improve people’s understanding of key concepts in assessing the effects of health interventions: a systematic review.Systematic reviews. 2018; 7:1-2.
Castle JC, Chalmers I, Atkinson P, Badenoch D, Oxman AD, Austvoll-Dahlgren A, Nordheim L, Krause LK, Schwartz LM, Woloshin S, Burls A.Establishing a library of resources to help people understand key concepts in assessing treatment claims—the “Critical thinking and Appraisal Resource Library”(CARL).PLoS One. 2017; 12(7):e0178666.
Austvoll-Dahlgren A, Guttersrud Ø, Nsangi A, Semakula D, Oxman AD, The IHC group.Measuring ability to assess claims about treatment effects: a latent trait analysis of items from the ‘Claim Evaluation Tools’ database using Rasch modelling. BMJ open. 2017; 7(5):e013185.
Cusack L, Desha LN, Del Mar CB, Hoffmann TC.A qualitative study exploring high school students’ understanding of, and attitudes towards, health information and claims. Health Expectations.2017; 20(5):1163-71.
Cusack L, Del Mar CB, Chalmers I, Hoffmann TC.Educational interventions to improve people’s understanding of key concepts in assessing the effects of health interventions: a systematic review protocol. Systematic reviews. 2016; 5:37.
Sharples JM, Oxman AD, Mahtani KR, Chalmers I, Oliver S, Collins K, Austvoll-Dahlgren A, Hoffmann T.Critical thinking in healthcare and education. BMJ. 2017; 357:j2234.

Effectiveness of health apps and their potential in enhancing self-management in primary care

Byambasuren O, Beller E, Hoffmann T, Glasziou P. Barriers to and Facilitators of the Prescription of mHealth Apps in Australian General Practice: Qualitative Study. JMIR mHealth and uHealth. 2020; 8(7):e17447.
Byambasuren O, Beller E, Hoffmann T, Glasziou P. mHealth app prescription in Australian general practice: Pre-post study. JMIR mHealth and uHealth. 2020; 8(6):e16497.
Byambasuren O, Beller E, Glasziou P. Current knowledge and adoption of mobile health apps among Australian general practitioners: survey study. JMIR mHealth and uHealth. 2019; 7(6), e13199.
Byambasuren O, Sanders S, Beller E, Glasziou P. Prescribable mHealth apps identified from an overview of systematic reviews. npj Digital Medicine. 2018; 1:1

Patient decision aids: development, evaluation, and criteria for them

Zadro JR, Karunaratne S, Harris IA, Jones CMP, O’Keeffe M, Ferreira GE, Buchbinder R, McCaffery K, Thompson R, Maher CG, Hoffmann T. The impact of a patient decision aid on intention to undergo surgery for subacromial pain syndrome: An online randomised controlled trial. Patient Education and Counselling. 2022; 105(9):2951-2961. doi: 10.1016/j.pec.2022.05.005
Gan JFL, McKay M, Jones CMP, Harris IA, McCaffery K, Thompson R, Hoffmann TC, Adie S, Maher CG, Zadro JRJ. Developing a patient decision aid for Achilles Tendon rupture management: a mixed-methods study. BMJ Open. 2023; 13:e072553. doi: 10.1136/bmjopen-2023-072553.
Hoffmann T, Bakhit M, Durand MA, Perestelo-Pérez L, Saunders C, Brito JP. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: an update from the International Patient Decision Aid Standards. Medical Decision Making. 2021; 41:755-767.
Scalia P, Saunders C, Dannenberg M, Giguere A, Alper B, Hoffmann T, Perestelo‐Perez L, Durand M, Elwyn G. Processes for evidence summarization for patient decision aids: a Delphi consensus study. Health Expectations. 2021; 24, 1179-1187.
Sharma S, Traeger A, O’Keefe M, Copp T, Freeman A, Hoffmann T, Maher C. Effect of information format on intention and beliefs regarding diagnostic imaging for non-specific low back pain: a randomised controlled trial in members of the public. Patient Education and Counselling. 2021; 104(3):595-602.
Stacey D, Volk RJ, for the IPDAS Evidence Update Leads (Hilary Bekker, Karina Dahl Steffensen, Tammy C Hoffmann, Kirsten McCaffery, Rachel Thompson, Richard Thomson, Lyndal Trevena, Trudy van der Weijden, Holly Witteman) The International Patient Decision Aid Standards (IPDAS) Collaboration: Evidence Update 2.0. Medical Decision Making. 2021; 41:729-733.
Martin R, Brogård Andersen S, O'Brien M, Bravo Valenzuela P, Hoffmann T, Olling K, Shepherd H, Dankl K, Stacey D, Dahl Steffensen K. Providing balanced information about options in patient decision aids: an update from the International Patient Decision Aid Standards. Medical Decision Making. 2021; 41:780-800.
Zadro J, Jones C, Harris I, Buchbinder R, O'Connor DA, McCaffery K, Thompson RE, Karunaratne S, Teng MJ, Maher C, Hoffmann T. Development of a patient decision aid on subacromial decompression surgery and rotator cuff repair surgery: an international mixed-methods study. BMJ Open. 2021; 11:e054032. doi: 10.1136/bmjopen-2021-054032.
Durand M, Dannenberg MD, Saunders CH, Giguere AMC, Alper BS, Hoffmann T, Perestelo-Pérez L, Campbell ST, Elwyn G. Modified Delphi survey for the evidence summarisation of patient decision aids: Study protocol. BMJ Open, 2019;9:e026701.

Informed decisions about antibiotic use

Hoffmann TC, Jones M, Glasziou P, Beller E, Trevena L, Del Mar C. A brief shared decision-making intervention for acute respiratory infections on antibiotic dispensing rates in primary care: a cluster randomized trial. Annals of Family Medicine. 2022; 20(1):35-41.
Mar CD, Hoffmann T, Bakhit M. How can general practitioners reduce antibiotic prescribing in collaboration with their patients?. Australian Journal of General Practice. 2022; 51(1/2):25-30.
Hoffmann TC, Bakhit M, Del Mar C. Methenamine hippurate for recurrent urinary tract infections. BMJ. 2022; 376:0533.
Bakhit M, Del Mar C, Gibson E, Hoffmann T. Exploring patients’ understanding of antibiotic resistance and how this may influence attitudes towards antibiotic use for acute respiratory infections: a qualitative study in Australian general practice. BMJ open. 2019; 9(3):e026735.
Bakhit M, Del Mar C, Gibson E, Hoffmann T. Shared decision making and antibiotic benefit-harm conversations: an observational study of consultations between general practitioners and patients with acute respiratory infections. BMC family practice. 2018; 19:165.
Coxeter PD, Del Mar CB, Hoffmann TC. Preparing parents to make an informed choice about antibiotic use for common acute respiratory infections in children: a randomised trial of brief decision aids in a hypothetical scenario. The Patient-Patient-Centered Outcomes Research. 2017; 10:463-74.
McCullough AR, Parekh S, Rathbone J, Del Mar CB, Hoffmann TC. A systematic review of the public's knowledge and beliefs about antibiotic resistance. Journal of Antimicrobial Chemotherapy. 2016; 71(1):27-33.
Coxeter P, Del Mar CB, McGregor L, Beller EM, Hoffmann TC. Interventions to facilitate shared decision making to address antibiotic use for acute respiratory infections in primary care. Cochrane Database of Systematic Reviews. 2015; 11:CD010907.
Hansen MP, Howlett J, Del Mar C, Hoffmann TC. Parents’ beliefs and knowledge about the management of acute otitis media: a qualitative study. BMC family practice. 2015; 16:1-7.
Gillies M, Ranakusuma A, Hoffmann T, Thorning S, McGuire T, Glasziou P, Del Mar C. Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication. CMAJ. 2015; 187(1):E21-31.

Collaborators

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Grants

Current grants

NHMRC Senior Research Fellowship: Prof Tammy Hoffmann OAM - Using shared decision making to improve the appropriateness of healthcare for individuals and the system (1/1/2019—31/3/2025)
National Heart Foundation Vanguard Grant: A novel strategy for improving the prescription of effective non-drug interventions for the prevention and management of cardiovascular disease in primary care - the 'e-HANDI': a codesign and feasibility trial (1/01/2023-1/01/2024)

Previous grants

A NHMRC Centre for Research Excellence (Ask, Share, Know: Rapid Evidence for General Practice Decisions) to improve the uptake of evidence-based practice and shared decision making in primary care. This CRE and its network of general practices identifies clinical issues and develops and tests evidence summaries and decision-making tools to solve these issues.
A NHMRC Project Grant that is exploring the use of shared decision making about antibiotic use for acute respiratory infections in primary care.

Projects for the ACSQHC to develop and test shared decision making online training module for health professionals and patient decision aids.
Projects for the ACI to implement and evaluate shared decision making interventions, and SDM training
Project for RACGP-Therapeutic Guidelines to evaluate the usability and effectiveness of additional guideline features to enhance prescribing decisions in general practice.