Updated International Patient Decision Aid Standards (IPDAS version 5.0): modified Delphi, evidence informed consensus process

CCBYNC Open access Research Methods & Reporting Updated International Patient Decision Aid Standards (IPDAS version 5.0): modified Delphi, evidence informed consensus process BMJ 2026; 393 doi: https://doi.org/10.1136/bmj-2025-088116 (Published 12 June 2026) Cite this as: BMJ 2026;393:e088116 Article Related content Metrics Responses Peer review Robert J Volk, distinguished professor in cancer research1,Krystina B Lewis, associate professor2,Maureen Smith, patient partner3,Meg Carley, clinical research coordinator4,Michael J Barry, professor of medicine5,Hilary L Bekker, professor of medical decision making6,Martin Härter, professor7,Tammy Hoffmann, professor8,Kirsten McCaffery, professor9,Michael Pignone, Kirkland distinguished professor of medicine10,Karina Dahl Steffensen, dean and, professor11 12,Karen Sepucha, associate professor of medicine13,Rachel Thompson, associate professor14,Lyndal Trevena, professor emerita15,Trudy van der Weijden, professor of implementation of guidelines and shared decision making16,Holly O Witteman, professor17,Dawn Stacey, distinguished professor and senior scientist2 18 Author affiliations Correspondence to: R J Volk bvolk@mdanderson.org Accepted 10 April 2026 Patient decision aids (PDAs) are evidence informed tools designed to support patients in the process of making decisions about their health. The International Patient Decision Aid Standards (IPDAS) Collaboration last updated the standards in 2013 and the evidence about patient decision aids has expanded substantially. In this article, we report on an update to IPDAS that used a modified Delphi process with two rounds of voting to reach consensus on evidence informed changes to the criteria. The 202 participants were from 26 countries, and included patients/consumers, policy makers, researchers, and clinician researchers. IPDAS 5.0 includes seven qualifying criteria (necessary to be a patient decision aid), 10 essential criteria (necessary to reduce biased decisions), and 54 enhancing criteria (additional criteria that might improve the quality of a patient decision aid). The updated standards reflect the IPDAS Collaboration’s founding goal of providing high quality patient decision aids for patients that minimise potential biases in the decisions made about potential healthcare options.