Although the task of involving patients in decision-making tasks has become the focus of increasing attention over the last decade, there is also a realization that we struggle to measure what would constitute success in this area. Important questions remain, such as what constitutes a good decision or a high-quality decision and how to measure decision quality. We recognize that definitions of decision quality and other similar terms have been put forward. In this paper, it is our intention to examine these definitions, to highlight the ways in which they converge, and to explain why we have some concerns about their emphasis on post hoc evaluations. We proceed to offer an alternative, which parses ‘decisions’ into a pre-decisional process and a post-decisional outcome.

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