JACC: Advances Expert Panel Perspective

Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM. SDM is a bidirectional exchange between experts: patients are the experts on their goals, values, and preferences, and clinicians provide their expertise on clinical factors. In this Expert Panel perspective, we review the current state of SDM in team-based cardiovascular care and propose best practice recommendations for multidisciplinary team implementation of SDM. [Display omitted] •Evidence for SDM implementation is limited, and adoption is influenced by complex interpersonal, organizational, and environmental factors.•SDM is an ethical right in which the patient is the expert on their goals, values, and preferences and partners with clinical experts in CV care.•SDM in goal-based CV care must be implemented with a multidisciplinary, team-based approach, considering the attitudes, competencies, and processes that support success.•Future research efforts must assess the efficacy and effectiveness of team-based SDM to improve adoption and further guide implementation.