Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) (2012) 106, 235—237 Available online at www.sciencedirect.com journal homepage: www.elsevier.de/zefq EDITORIAL No EBM without SDM: Give us a measure to capture patient involvement and we will move the health system Dr. rer. medic. Fülöp Scheibler Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) E-Mail: fueloep.scheibler@iqwig.de Hardy Müller Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen Geschäftsführer Aktionsbündnis Patientensicherheit e.V E-Mail: hardy.mueller@wineg.de France Légaré CHUQ Research Centre-Hôpital St-Franc ¸ois d’Assise Quebec, Canada E-Mail: France.Legare@mfa.ulaval.ca Dr. phil. Jürgen Kasper Institut für Allgemeinmedizin, Universitätsklinikum Hamburg Eppendorf und Gesundheitswissenschaften, MIN Fakultät Universität Hamburg E-Mail: k@sper.info Evidence based medicine (EBM) is a practice based not only on the consideration of best research evidence but also on clinical expertise and patient values [1]. It therefore stands to reason that medical care with- out the systematic involvement of patients can no sooner be called EBM than can medical care that fails to con- sider systematic evaluation of the research evidence [2]. EBM and shared decision making (SDM) have entered into the medical and health policy debate. However, in everyday practice, SDM continues to play only a marginal role, as illustrated by the following quote from a female patient suffering for over 20 years from a severe chronic condition: ‘‘I can’t understand the academic discussion around SDM. It is completely disconnected from the day-to-day real- ity of patients like myself. In the real world, patients are not involved in even the most basic treatment decisions, while at the same time a highly sophisticated debate on SDM rages on in academia. Can’t anyone let these aca- demics know that they are on their way to the moon while patients remain earthbound and speechlessly watch the show?’’ This quote illustrates what has been validly measured in large multinational studies: The extent to which patients are involved in treatment decisions remains far below their expectations [3—5]. Over the years, researchers have developed valid meth- ods to assess the systematic and scientific approach of evidence reports and to evaluate the methodological quality of clinical practice guidelines aggregating clinical expertise and preferences. However, if and how patients can be included – consistently and systematically – in treatment decisions lacks empirical support. Universal agreement on standards is scant. The IPDASi is an instrument used to assess the quality of decision support technologies, but we still lack standards to assess the quality of patient needs 1865-9217/$ – see front matter http://dx.doi.org/10.1016/j.zefq.2012.04.006