1. Talking about risk

2. Spot the odd one out! Hyperlipidaemia Rheumatoid arthritis Eczema Bronchiolitis

3. Spot the odd one out! Fasting blood glucose 7.5 PSA 7.5 Serum potassium 6.0 Ferritin 30

4. Salzburg statement on shared decision making Ethical imperative to share important decision making Stimulate a two way flow of information Provide accurate information about options, uncertainties, benefits and harms Tailor information to individual patient needs and allow time for consideration Acknowledge that most decisions do not have to be taken immediately

5. Children age 6m to 2y, bilateral AOM at 3-7 days treated with antibiotics

6. Harms of antibiotics age 6m to 15y

7. Consultation steps Describe the clinical condition Explore ICE My friend John Statement as a question Square search Describe the options and outline the dilemma Offer a more detailed discussion Work through the PDA Allow the patient time for consideration. Offer a copy of the PDA

8. Cautions Balance the discussion including both positive and negative sides Try to use phrases such as ‘a patient like you’ Beware of the ‘friend of a friend’ Explore understanding of severity of risk

9. http://www.npc.nhs.uk/evidence/eidm3_ind ividuals/movie/index.phphttp://www.npc.nhs.uk/evidence/eidm3_ind ividuals/movie/index.php