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How to use the patient decision aid

Patient Decision Aid: Torbay Charts

Torbay and South Devon NHS Foundation Trust


Torbay Charts© is a patient decision aid conceived by Mr Raju Ramesh (Trauma & Orthopaedic Surgeon).

This unique and innovative PDA matches treatment options available based on the stage of the disease and presents information in a multi-layered approach.

Layer 1: An overview of disease progression and the treatment options appropriate at each stage.

Layer 2: Presents a concise description of each treatment including an indication of the impact on the patient vs potential benefit. This information is presented as infographics covering information across ten domains, including descriptor of the treatment, benefits, risks, burden to patient and indicative cost of treatment. Links to educational videos and other sources of accredited patient information are incorporated.

Layer 3: Allows user driven interactive comparisons of treatment options with results displayed as a table or comparative infographics (which can be captured as pdf’s for downloading or printing.

Torbay Charts is presented as a web-based interactive platform (www.torbaycharts.co.uk) to which patients can be directed either before or after a consultation. A hard copy version of the first layer of information has been produced which has proven very beneficial in supporting face-to-face consultations.


HCI were integral in the scoping, design, build, testing of the PDA and its development into being adapted for us with other long term conditions.


Survey results from 107 participants during alpha testing at Torbay Hospital show that:

  • Over 92% felt that the tool enabled their SDM discussion
  • Over 93% felt that the tool made them appreciate the various options that are available for them
  • 5% of patients attending a consultation with the anticipation of being listed for a surgical intervention opted for a non-operative intervention
  • The single page printed format makes it extremely easy to use during clinical consultation (without increasing the time spent) and enhances the shared decision making process
  • The web version enables patients to explore various options that suit their preference at their own pace at home and review the information discussed at the consultation