Purpose: Despite limited evidence regarding the way in which personal stories in patient decision aids impact decision making, they are a common feature of decision aids that are widely available to the public. Our purpose was to characterize the personal stories in current, publicly available patient decision aids and describe their variability.

Methods: A random, stratified sample of eligible decision aids was taken from the updated 2007 Cochrane A-Z Inventory of Patient Decision Aids [http://decisionaid.ohri.ca/AZinvent.php].

Decision aids met the following inclusion criteria:

1. meet the Cochrane definition of a decision aid; 2. be publicly available; 3. contain at least one personal story that meets the definition: “an illustrative, first-person narrative in text, video and/or audio format.”

The number of personal stories per decision aid was calculated and the features of each were classified by two independent reviewers using a structured coding taxonomy employing concepts and their definitions from the Ottawa Decision Support Framework.

Results: Of the 200 decision aids in the Inventory, 168 met inclusion criteria. Our sample (n=56) contained 260 personal stories.

All decision aids in the sample contained stories in which subjects favour an option. Fifty-four percent of decision aids contain an equal ratio of personal stories favouring and against the most intensive option in the decision aid.

Fewer decision aids, forty-three percent, contain stories that describe the outcome(s) of a chosen option.

Many stories describing the outcome(s) also portray the subject's satisfaction or dissatisfaction with an outcome(s) of the chosen option. Of those decision aids containing stories portraying satisfaction or dissatisfaction with outcomes, seventy percent contained ONLY stories that portray subjects as satisfied. Thirty percent included at least one story portraying satisfaction AND at least one story portraying dissatisfaction with outcomes.

Stories also varied in their portrayal of decision support elements and effective decisions.

Conclusion: Publicly available decision aids vary in their use of stories. Most stories focus on the decision and less on the outcome. The balance in their presentation is variable. While most stories portray decisions and outcomes positively, few portray regret or dissatisfaction. Considering the wide public availability of these decision aids, a best practice for the inclusion of personal stories in patient decision aids is needed.