Informed consent and shared decision making are principles instilled in recent guidelines as class one recommendations, but what constitutes informed consent and how are decisions made in current practice? For the patient to be informed they must be made aware of the best evidence regarding treatments for their condition. These include evidence from trials and registries and guideline recommendations. This evidence must be understood to reflect primarily the results of trials filtered through experts to reflect the anticipated benefit or outcome of the average patient studied. The authors of guidelines do not know your patient, so how closely they resemble the patients in the studies is important information for the patient being informed. Is your patient similar to the average patient in studies of their condition? The patient should understand the concept of the bell-shaped curve and the fact that the population studied and the outcomes of studies are the average of many patients and outcomes across the spectrum. Your patient may be the average one, or toward one end or the other of the bell-shaped curve, or perhaps outside the population studied. The patient should also understand that the outcomes driving guidelines come from many participating centers, and so the local experience dealing with their condition is also critical information to understand. Many trials are powered to detect differences in composite endpoints. Patients may have heard that treatment “A” was shown to be better than treatment “B.” The patient does not need to know only about composite endpoints but also the individual outcomes such as death, myocardial infarction, stroke, and quality-of-life measures.