RT Journal Article SR Electronic T1 Short Graphic Values History Tool for decision making during serious illness JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2018-001698 DO 10.1136/bmjspcare-2018-001698 A1 John J You A1 Peter Allatt A1 Michelle Howard A1 Carole A Robinson A1 Jessica Simon A1 Rebecca Sudore A1 Amy Tan A1 Carrie Bernard A1 Marilyn Swinton A1 Xuran Jiang A1 Doug Klein A1 Michael McKenzie A1 Gillian Fyles A1 Daren Keith Heyland YR 2019 UL http://spcare.bmj.com/content/early/2019/02/06/bmjspcare-2018-001698.abstract AB Objectives To develop and validate a values clarification tool, the Short Graphic Values History Tool (GVHT), designed to support person-centred decision making during serious illness.Methods The development phase included input from experts and laypersons and assessed acceptability with patients/family members. In the validation phase, we recruited additional participants into a before–after study. Our primary validation hypothesis was that the tool would reduce scores on the Decisional Conflict Scale (DCS) at 1–2 weeks of follow-up. Our secondary validation hypotheses were that the tool would improve values clarity (reduce scores) more than other DCS subscales and increase engagement in advance care planning (ACP) processes related to identification and discussion of one’s values.Results In the development phase, the tool received positive overall ratings from 22 patients/family members in hospital (mean score 4.3; 1=very poor; 5=very good) and family practice (mean score 4.5) settings. In the validation phase, we enrolled 157 patients (mean age 71.8 years) from family practice, cancer clinic and hospital settings. After tool completion, decisional conflict decreased (−6.7 points, 95% CI −11.1 to −2.3, p=0.003; 0–100 scale; N=100), with the most improvement seen in the values clarity subscale (−10.0 points, 95% CI −17.3 to −2.7, p=0.008; N=100), and the ACP-Values process score increased (+0.4 points, 95% CI 0.2 to 0.6, p=0.001; 1–5 scale; N=61).Conclusions The Short GVHT is acceptable to end users and has some measure of validity. Further study to evaluate its impact on decision making during serious illness is warranted.