TY - JOUR
T1 - Decision aids for patients facing health treatment or screening decisions
T2 - Systematic review
AU - O'Connor, Annette
AU - Rostom, Alaa
AU - Fiset, Valerie
AU - Tetroe, Jacqueline
AU - Entwistle, Vikki
AU - Llewellyn-Thomas, Hilary
AU - Holmes-Rovner, Margaret
AU - Barry, Michael
AU - Jones, Jean
N1 - Medline is the source for the MeSH terms of this document.
PY - 1999/9/18
Y1 - 1999/9/18
N2 - Objective. To conduct a systematic review of randomised trials of patient decision aids in improving decision making and outcomes. Design. We included randomised trials of interventions providing structured, detailed, and specific information on treatment or screening options and outcomes to aid decision making. Two reviewers independently screened and extracted data on several evaluation criteria. Results were pooled by using weighted mean differences and relative risks. Results. 17 studies met the inclusion criteria. Compared with the controls, decision aids produced higher knowledge scores (weighted mean difference = 19/100, 95% confidence interval 14 to 25); lower decisional conflict scores (weighted mean difference = -0.3/5, -0.4 to -0.1); more active patient participation in decision making (relative risk = 2.27, 95% confidence interval 1.3 to 4); and no differences in anxiety, satisfaction with decisions (weighted mean difference = 0.6/100, -3 to 4), or satisfaction with the decision making process (2/100, -3 to 7). Decision aids had a variable effect on decisions. When complex decision aids were compared with simpler versions, they were better at reducing decisional conflict, improved knowledge marginally, but did not affect satisfaction. Conclusions. Decision aids improve knowledge, reduce decisional conflict, and stimulate patients to be more active in decision making without increasing their anxiety. Decision aids have little effect on satisfaction and a variable effect on decisions. The effects on outcomes of decisions (persistence with choice, quality of life) remain uncertain.
AB - Objective. To conduct a systematic review of randomised trials of patient decision aids in improving decision making and outcomes. Design. We included randomised trials of interventions providing structured, detailed, and specific information on treatment or screening options and outcomes to aid decision making. Two reviewers independently screened and extracted data on several evaluation criteria. Results were pooled by using weighted mean differences and relative risks. Results. 17 studies met the inclusion criteria. Compared with the controls, decision aids produced higher knowledge scores (weighted mean difference = 19/100, 95% confidence interval 14 to 25); lower decisional conflict scores (weighted mean difference = -0.3/5, -0.4 to -0.1); more active patient participation in decision making (relative risk = 2.27, 95% confidence interval 1.3 to 4); and no differences in anxiety, satisfaction with decisions (weighted mean difference = 0.6/100, -3 to 4), or satisfaction with the decision making process (2/100, -3 to 7). Decision aids had a variable effect on decisions. When complex decision aids were compared with simpler versions, they were better at reducing decisional conflict, improved knowledge marginally, but did not affect satisfaction. Conclusions. Decision aids improve knowledge, reduce decisional conflict, and stimulate patients to be more active in decision making without increasing their anxiety. Decision aids have little effect on satisfaction and a variable effect on decisions. The effects on outcomes of decisions (persistence with choice, quality of life) remain uncertain.
UR - http://www.scopus.com/inward/record.url?scp=0033581375&partnerID=8YFLogxK
U2 - 10.1136/bmj.319.7212.731
DO - 10.1136/bmj.319.7212.731
M3 - Article
AN - SCOPUS:0033581375
SN - 0959-8146
VL - 319
SP - 731
EP - 734
JO - British Medical Journal
JF - British Medical Journal
IS - 7212
ER -