Competing interests: GE has edited and published books that provide royalties on sales by the publishers: the books include Shared Decision Making (Oxford University Press) and Groups (Radcliffe Press). He has in the past provided consultancy for (1) Emmi Solutions, which develops patient decision support tools; (2) National Quality Forum on the certification of decision support tools; (3) Washington State Health Department on the certification of decision support tools; and (4) SciMentum, Amsterdam (workshops for shared decision making). He is the Director of &think, which owns the registered trademark for Option Grids patient decision aids. He provides consultancy in the domain of shared decision making and patient decision aids to (1) Access Community Health Network, Chicago (Federally Qualified Medical Centers), and to (2) EBSCO Health Option Grids patient decision aids. GE initiated the Option Grid Collaborative, tools that are hosted on a website managed by Dartmouth College, on http://optiongrid.org/. Existing Option Grids hosted on this website are freely available until such time as the tools have expired. He owns copyright on measures of shared decision making and care integration, namely collaboRATE, integRATE and Observer OPTION. These measures are freely available for use. EN holds stock in a quality measurement company (Quality Data Management). AP is the patient editor for research and evaluation at The BMJ. No other conflicts to report.