Shared decision-making (SDM) integrates clinical evidence with patient preferences in established healthcare systems. More and more countries are focusing on the role of SDM in clinical settings and specific implementation strategies. However, the global distribution of research on SDM is extremely unequal, and there are also significant differences in the perception of SDM across regions and cultures. Therefore, it is necessary to discuss in depth the East-West differences of SDM in the hope of laying the foundation for future global SDM development in an equitable manner. In this analysis, we discuss cultural differences in SDM in a broad sense: the development of SDM, collectivism and the role of the family in SDM, challenges in the communication, etc. These issues may provide new insights to address the global development and implementation of SDM. In Western countries (defined as dominance of Western ideology, such as the European Union and the Five Eyes Alliance, an intelligence-

Shared decision-making (SDM) integrates clinical evidence with patient preferences in established healthcare systems. More and more countries are focusing on the role of SDM in clinical settings and specific implementation strategies. However, the global distribution of research on SDM is extremely unequal, and there are also significant differences in the perception of SDM across regions and cultures. Therefore, it is necessary to discuss in depth the East-West differences of SDM in the hope of laying the foundation for future global SDM development in an equitable manner. In this analysis, we discuss cultural differences in SDM in a broad sense: the development of SDM, collectivism and the role of the family in SDM, challenges in the communication, etc. These issues may provide new insights to address the global development and implementation of SDM. In Western countries (defined as dominance of Western ideology, such as the European Union and the Five Eyes Alliance, an intelligence-

Shared decision-making (SDM) integrates clinical evidence with patient preferences in established healthcare systems. More and more countries are focusing on the role of SDM in clinical settings and specific implementation strategies. However, the global distribution of research on SDM is extremely unequal, and there are also significant differences in the perception of SDM across regions and cultures. Therefore, it is necessary to discuss in depth the East-West differences of SDM in the hope of laying the foundation for future global SDM development in an equitable manner. In this analysis, we discuss cultural differences in SDM in a broad sense: the development of SDM, collectivism and the role of the family in SDM, challenges in the communication, etc. These issues may provide new insights to address the global development and implementation of SDM. In Western countries (defined as dominance of Western ideology, such as the European Union and the Five Eyes Alliance, an intelligence-

The development of knowledge is for the most part a gradual and iterative process by which every new study either confirms, extends or refutes what has been reported in previous ones. In evidence-based medicine, ideally a finding should be replicated by multiple studies before it can inform policy or practice decisions. While there is ongoing debate about the exact definition of replication, it is clear that replication has an irrefutable role in establishing the credibility of scientific findings.1 Nearly two decades ago, scientists declared a ‘replication crisis’ on demonstrating that results of a disproportionately high number of published studies in psychology and medicine could not be replicated.2 3 Under the pressure of academic policies and norms that incentivise novelty and positive findings, researchers have been steering away from replication studies, favouring publishability over credibility.1 4 Several interventions and solutions have since emerged in response to the crisis

The development of knowledge is for the most part a gradual and iterative process by which every new study either confirms, extends or refutes what has been reported in previous ones. In evidence-based medicine, ideally a finding should be replicated by multiple studies before it can inform policy or practice decisions. While there is ongoing debate about the exact definition of replication, it is clear that replication has an irrefutable role in establishing the credibility of scientific findings.1 Nearly two decades ago, scientists declared a ‘replication crisis’ on demonstrating that results of a disproportionately high number of published studies in psychology and medicine could not be replicated.2 3 Under the pressure of academic policies and norms that incentivise novelty and positive findings, researchers have been steering away from replication studies, favouring publishability over credibility.1 4 Several interventions and solutions have since emerged in response to the crisis

The development of knowledge is for the most part a gradual and iterative process by which every new study either confirms, extends or refutes what has been reported in previous ones. In evidence-based medicine, ideally a finding should be replicated by multiple studies before it can inform policy or practice decisions. While there is ongoing debate about the exact definition of replication, it is clear that replication has an irrefutable role in establishing the credibility of scientific findings.1 Nearly two decades ago, scientists declared a ‘replication crisis’ on demonstrating that results of a disproportionately high number of published studies in psychology and medicine could not be replicated.2 3 Under the pressure of academic policies and norms that incentivise novelty and positive findings, researchers have been steering away from replication studies, favouring publishability over credibility.1 4 Several interventions and solutions have since emerged in response to the crisis

The development of knowledge is for the most part a gradual and iterative process by which every new study either confirms, extends or refutes what has been reported in previous ones. In evidence-based medicine, ideally a finding should be replicated by multiple studies before it can inform policy or practice decisions. While there is ongoing debate about the exact definition of replication, it is clear that replication has an irrefutable role in establishing the credibility of scientific findings.1 Nearly two decades ago, scientists declared a ‘replication crisis’ on demonstrating that results of a disproportionately high number of published studies in psychology and medicine could not be replicated.2 3 Under the pressure of academic policies and norms that incentivise novelty and positive findings, researchers have been steering away from replication studies, favouring publishability over credibility.1 4 Several interventions and solutions have since emerged in response to the crisis