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However, confusion and challenges remain toward how it is conceptualized and measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This umbrella review aimed to establish how informed choice is operationalized in health care and the characteristics and performance of the most commonly used measurement instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Four electronic databases (Ovid MEDLINE, Ovid EMBASE, APA PsycINFO, and Cochrane Library) were searched up to January 29, 2024. Reference lists of included studies were hand searched for further relevant publications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>After the titles and abstracts of 10,434 articles were screened by one reviewer and 10% were screened by a second reviewer for consistency, 2 reviewers independently screened 60 full-text articles for inclusion. Key eligibility criteria included systematic reviews in adult health care settings where the aim included an evaluation of measures of informed choice. Sixteen articles were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>\n                      Data were independently extracted by 2 reviewers using a standardized template.\n                      <jats:italic toggle=\"yes\">Data Synthesis.<\/jats:italic>\n                      Data were synthesized using the summarization technique with systematic reviews as the main unit of analysis and additional subanalysis of primary measurement instruments identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Heterogeneous definitions complicate search strategies, and eligibility criteria may limit external validity. The ROBIS appraisal identified many reviews as high risk of bias, limiting the conclusions drawn. Due to heterogeneity, meta-analysis was not possible, and conclusions were limited to narrative reviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There remains no consensus on how informed choice should be conceptualized and measured within health care. This review attempts to bridge these gaps by presenting available concepts and instruments for clinicians, researchers, and policy makers. Future recommendations include achieving consistent definitions of informed choice and related concepts, followed by the use of standardized, validated, multidimensional instruments informed by theory in diverse populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Informed choice is of key importance and increasingly emphasized across health care.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Despite this importance, confusion and challenges remain regarding how informed choice is conceptualized and measured in health care.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Consistent definitions and the use of standardized, validated, multidimensional instruments, informed by theory and patients themselves, in diverse populations should be the first steps to improve this.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>These recommendations apply to all in health care, including health professionals, researchers, and policy makers.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x251413276","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T06:55:30Z","timestamp":1773644130000},"page":"501-526","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Operationalizing and Measuring Informed Choice in Health Care: An Umbrella Review"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1029-9144","authenticated-orcid":false,"given":"Holly","family":"Sprosen","sequence":"first","affiliation":[{"name":"General Surgery Department, Middlemore Hospital, Auckland, New Zealand"},{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8908-0817","authenticated-orcid":false,"given":"Chiara","family":"Re","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge, Cambridge Biomedical Centre, Cambridge, UK"},{"name":"IRCCS San Raffaele Hospital, Unit of Urology, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-9140","authenticated-orcid":false,"given":"Grant D.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Cambridge, Cambridge Biomedical Centre, Cambridge, UK"},{"name":"CRUK Cambridge Centre, University of Cambridge, Cambridge Biomedical Centre, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8501-2531","authenticated-orcid":false,"given":"Juliet A.","family":"Usher-Smith","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","unstructured":"World Medical Association. 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