Annette M. O'Connor

Dr. O’Connor’s novel measures, frameworks and interventions have contributed to the emergence of a new field of ‘shared decision making’. Her ground-breaking studies have created new knowledge, tools and standards for informing people about difficult decisions and have underpinned new policies and legislation internationally to promote shared decision making between patients and health professionals. Her leadership has been pivotal in creating an international academic forum for the field.

Dr. O’Connor’s leadership and innovative research was acknowledged with the prestigious Society for Medical Decision Making Career Achievement Award and the John Eisenberg Award for Exemplary Leadership in the Application of Medical Decision Making. She is a fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences and was appointed Officer of the Order of Canada. For 18 consecutive years she held career scientist awards including a Tier 1 Canada Research Chair. Dr. O’Connor is a Distinguished University Professor at the University of Ottawa.

2020: Laureate, Canadian Medical Hall of Fame
2018: Officer, Order of Canada
2013: Fellow, Royal Society of Canada

• Development and evaluation of decision aids
• Decision support evaluation methods
• Frameworks of decision support as a clinical skill

• Ottawa Hospital Research Institute Patient Decision Aids Research Group

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Key Contributions (*Research Trainees)

Widely used evaluation measure

• O'Connor, A.M. Validation of a decisional conflict scale. Medical Decision Making. 15(1):25-30, 1995.
• *Garvelink MM, *Boland L, Klein K, Nguyen DV, Menear M, Bekker HL, Eden KB, LeBlanc A, O'Connor AM, Stacey D, Légaré F.et al. Decisional Conflict Scale Use over 20 Years: The Anniversary Review. Medical Decision Making. 2019;39(4):301-314.
• *Garvelink MM, Boland L, Klein K, Nguyen DV, Menear M, Bekker HL, Eden KB, LeBlanc A, O'Connor AM, Stacey D, Légaré F. Decisional Conflict Scale Findings among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review. Medical Decision Making. 2019;39(4):315-326.

Conceptual framework: decision support as a clinical skill

• O’Connor A, Tugwell P, Wells G, Elmslie T, Jolly E, Hollingworth G, McPherson R, Bunn H, *Graham I, Drake E. A decision aid for women considering hormone therapy after menopause: Decision support framework and evaluation. Patient Education and Counselling. 33(3):267-279, March 1998.
• *Légaré F, O’Connor AM, Graham ID, Wells G, Tremblay S. Impact of the Ottawa Decision Support Framework on the agreement and the difference between patients and physicians decisional conflict. Medical Decision Making. 2006 Jul-Aug;26(4):373-90.
• Stacey D, Légaré F, *Boland L, Lewis KB, Loiselle MC, *Hoefel L, Garvelink M, O’Connor A. 20th Anniversary Ottawa Decision Support Framework: Part 3 Overview of Systematic Reviews and Updated Framework. Medical Decision Making 2020 40:3, 379-398.

Randomized trials of patient decision aids

• O’Connor A, Tugwell P, Wells G, Elmslie T, Jolly E, Hollingworth G, McPherson R, Drake E, Hopman W, MacKenzie T. Randomized trial of a portable, self-administered decision aid for post-menopausal women considering long-term preventive hormone therapy. Medical Decision Making. 18(3):295-303, 1998.
• *Man-Son-Hing M, Laupacis A, O’Connor A, Wells, G., Lemelin, J., Wood, W., Dermer, M. A Patient Decision Aid Regarding Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation. A Randomized Controlled Trial. JAMA 282(8):737-743, 1999.
• *Vandemheen KL, O’Connor A, Bell SC, Freitag A, Bye P, Jeanneret A, Berthiaume Y, Brown N, Wilcox P, Ryan G, Brager N, Rabin H, Morrison N, Gibson P, Jackson M, Paterson N, Middleton P, Aaron SD. Randomized Trial of a Decision Aid for Cystic Fibrosis Patients Considering Lung Transplantation. American Journal of Respiratory and Critical Care Medicine2009;180(8):761-8
• *Hoefel, L, Lewis, KB, O’Connor, AM, Stacey, D. 20th Anniversary Update of the Ottawa Decision Support Framework: Part 2 Sub-analysis of a Systematic Review of Patient Decision Aids. Medical Decision Making 2020 (in press).

Methodological issues in developing/evaluating patient decision aids

• O’Connor AM, Fiset V, *DeGrasse C, Graham I, Evans W, *Stacey D, Laupacis A, Tugwell P. Decision aids for patients considering options affecting cancer outcomes: Evidence of efficacy and policy implications. Journal of the National Cancer Institute Monographs 25:67-80, 1999.

First large-scale surveys of physicians’ attitudes toward decision support

• O’Connor, A., Llewellyn-Thomas, H., Sawka, C., Pinfold, S., To, T., Harrison, D. Physicians’ opinions about decision aids for patients considering systemic adjuvant therapy for axillary-node negative breast cancer. Patient Education and Counseling. 30:143-153, 1997.
• *McNeely, PD, Hebert, PC, Dales, RE, O’Connor, AM, Wells, G., McKim, MD., & Sullivan, KE. Deciding about mechanical ventilation in end-stage chronic obstructive pulmonary disease: how respirologists perceive their role. Canadian Medical Association Journal 1997;156(2):177-183.

First systematic review of trials of patient decision aids

• O’Connor A, *Rostom A, *Fiset V, Tetroe J, Entwistle V, Llewellyn-Thomas H, Holmes-Rovner M, Barry M, Jones J. Decision aids for patients facing health treatment or screening decisions: A Cochrane systematic review. British Medical Journal319(7212):731-734, 1999

First national survey of a population’s health decisional needs

• O’Connor AM, Drake ER, Wells GA, Tugwell P, Laupacis A, Elmslie T. A survey of the decision-making needs of Canadians faced with complex health decisions. Health Expectations, 6(2):97-109, 2003.

First trials to improve decision support skills of health coaches

• *Stacey D, O’Connor A., Graham I, Pomey MP. Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre. Journal of Telemedicine and Telecare 2006; 12:410-415.
• *Murray MA, Stacey D, Wilson KG, O'Connor AM. Skills training to support patients considering place of end-of-life care: a randomized control trial. J Palliat Care. 2010 Summer;26(2):112-21

First international standards for patient decision aids

• Elwyn G, O'Connor A, Stacey D, Volk R, Edwards A, Coulter A, Thomson R, Barratt A, Barry M, Bernstein S, Butow P, Clarke A, Entwistle V, Feldman-Stewart D, Holmes-Rovner M, Llewellyn-Thomas H, Moumjid N, Mulley A, Ruland C, Sepucha K, Sykes A, Whelan T. The International Patient Decision Aids Standards (IPDAS) Collaboration. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. British Medical Journal. 2006 Aug 26;333(7565):417.

Policy paper on implementing patient decision aids

• O’Connor A, Wennberg J, Légaré F, Llewellyn-Thomas H, Moulton B, Sepucha K, Sodano A, Staples King J. Towards the Tipping Point: Accelerating the diffusion of decision aids that help patients to weigh benefits versus risks. Health Affairs 2007; 26(3).

First Canadian case study of implementing shared decision making in a health service

• *Stacey D, Pomey M-P, O’Connor A, Graham I. Adoption and sustainability of decision support for patients facing health decisions: An implementation case study in nursing. BMC Implementation Science. 2006 Aug 24; 1:17.