ISPOR Review of 50 Studies Finds Preference-Based Decision Tools Are on the Rise—but Evidence on What Works Isn’t Keeping Pace
Lawrenceville, NJ, USA—August 18, 2026—Value in Health, the official journal of ISPOR—The Professional Society for Health Economics and Outcomes Research, announced today the publication of a systematic literature review examining the use of preference-based value clarification methods to support value clarification and shared decision making. The article summarizes the existing literature and lays out a concrete research and reporting agenda to determine which approaches actually improve treatment decisions. The report, “A Systematic Review of Quantitative Health Preference Methods to Support Value Clarification and Shared-Decision Making: An ISPOR Special Interest Group Report,” was published in the August 2026 issue of Value in Health.
Shared decision making is a collaborative approach to healthcare in which patients and clinicians make medical decisions together. It combines the clinician's medical expertise with the patient's values, goals, and personal preferences to identify the diagnostic or treatment option that best aligns with the individual's needs and circumstances. Decision aids and other decision support tools can support shared decision making.
“Increasingly, patient decision aids include explicit value clarification methods that use quantitative preference elicitation methods. Historically, these methods were used to assess population level preferences. The use of these methods to support individual decision making is emerging,” said ISPOR Health Preference Research Chair and lead author, Janine van Til, PhD, Department of Health Technology and Services Research, University of Twente, The Netherlands. “Although individual studies report positive findings, variation in design and reporting hinders drawing general conclusions regarding whether preference-based value clarification methods improve decision-making processes and outcomes.”
Drawing on a systematic review of 50 studies, this new report explored the design and outcomes of preference-based value clarification methods used in the context of supporting patients' clinical decision making to understand whether guidance is used in the development of these methods and which is most effective.
Key findings:
- The most commonly used methods for preference-based value clarification in patient decision-support tools include adaptive conjoint analysis, the analytic hierarchy process, and simple ranking.
- Most studies that evaluated the feasibility and acceptability of using these tools reported positive results.
- No single preference-based value clarification method is proven best, highlighting the need for further comparative research on their impact on decision-making processes and outcomes.
The report offers developers several recommendations to help realize the potential for patient decision aids to improve decision making:
- Clearly explain the rationale for using a quantitative preference-based value clarification methods, considering the choice of a specific preference elicitation method, its theoretical strengths, attribute balance (to ensure no option is unfairly advantaged), and the user burden relative to the number and types of attributes included.
- Streamline and layer educational content within the patient decision aids and preference-based value clarification methods, aligning it with clinicians' responsibilities to provide information and discuss values, based on guidelines published by the International Patient Decision Aid Standards Collaboration.
- Use an iterative user-centered design process to improve the preference elicitation task, aiming to minimize patient and clinician burden, ensure understanding of the attributes and the elicitation process, and align the presentation of personalized preference information with user needs. Report on the iterative improvements made during feasibility testing, including contextual information that informed the design of a fit-for-purpose preference-based value clarification method.
- Researchers testing preference-based value clarification methods should use standardized outcome measures and employ comparative study designs.
The authors emphasize that closing this evidence gap will require coordinated effort across the field. As van Til notes, "future research should examine the effectiveness and feasibility of different preference-based value clarification methods, compare these to other value clarification method approaches, and explore its implementation in clinical practice." The data extraction form developed for the review, the authors suggest, could serve as a starting point for the standardized guidelines the field still needs.
Most critically, patient decision support tools are created to help patients. “Following best practices in creating a decision support tool means involving patients in creating the content, ensuring that the preference-based value clarification method reflects the trade-offs that patients actually make, and measuring outcomes that reflect shared decision making,” said project co-chair Holly L. Peay, PhD, Senior Director, Faegre Drinker Consulting, Washington, DC.
About ISPOR’s Health Preference Research Special Interest Group
Mission:
To provide leadership to advance the development, implementation and use of health preference research in support of health policy, the development of medical products, and patient care.
Goal:
- To foster discussions about known and novel methods to obtain preference information and to analyze health-preference data in support of standards for the use of these methods
- To support early career researchers interested in the field of health preference research through involvement in the Special Interest Group activities
- To facilitate the dissemination of good practices for the methods used to collect and analyze health preferences in the HEOR community
- To identify and highlight ways in which preference evidence can support patient care and health policy and health economics and outcomes research
Background:
Scientifically rigorous evidence on priorities and preferences is important in promoting patient-centered drug development, facilitating patient-centered outcomes research, informing regulatory benefit-risk analysis, and conducting robust health technology assessment. Health preference research focuses on the development of instruments and other mechanisms to measure preferences for aspects of health policies, medical products, and patient care. These aspects are systematically evaluated by relevant stakeholders to determine their relative importance. The resulting measures of relative importance offer a unique way to understand the value of health-related initiatives and products. The broad array of methods and the ability to modify them allows their use for any number of research questions.
Click to learn more about ISPOR’s Health Preference Research Special Interest Group.
Click to access the full-text article.
To cite this article: van Til JA, Peay HL, Osman A, et al. A systematic review of quantitative health preference methods to support value clarification and shared decision making: an ISPOR Special Interest Group Report. Value Health. 2026; 29(8):1329–1342.
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ABOUT ISPOR
ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s current impact factor score is 6.0 and its 5-year impact factor score is 5.7. Value in Health is ranked 5th of 124 journals in Health Policy and Services, 12th of 185 journals in Health Care Sciences & Services, and 37th of 617 journals in Economics. Value in Health is a monthly publication that circulates to more than 55,000 readers around the world.
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