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Do Patient Decision Aids Meet Effectiveness Criteria of the International Patient Decision Aid Standards Collaboration? A Systematic Review and Meta-analysis

Author

Listed:
  • Annette M. O'Connor

    (Ottawa Health Research Institute, Canada, University of Ottawa, Canada, ohdec@ohri.ca)

  • Dawn Stacey

    (University of Ottawa, Canada)

  • Michael J. Barry

    (Massachusetts General Hospital, Boston)

  • Nananda F. Col

    (Maine Medical Center, Portland, Maine)

  • Karen B. Eden

    (Oregon Health and Science University, Portland)

  • Vikki Entwistle

    (Social Dimensions of Health Institute, Dundee, UK)

  • Valerie Fiset

    (Algonquin College, Ottawa, Canada)

  • Margaret Holmes-Rovner

    (Michigan State University, East Lansing)

  • Sara Khangura

    (Ottawa Health Research Institute, Canada)

  • Hilary Llewellyn-Thomas

    (Dartmouth Medical School, Hanover, New Hampshire)

  • David R. Rovner

    (Michigan State University, East Lansing)

Abstract

Objective. To describe the extent to which patient decision aids (PtDAs) meet effectiveness standards of the International Patient Decision Aids Collaboration (IPDAS). Data sources. Five electronic databases (to July 2006) and personal contacts (to December 2006). Results. Among 55 randomized controlled trials, 38 (69%) used at least 1 measure that mapped onto an IPDAS effectiveness criterion. Measures of decision quality were knowledge scores (27 trials), accurate risk perceptions (12 trials), and value congruence with the chosen option (3 trials). PtDAs improved knowledge scores relative to usual care (weighted mean difference [WMD] = 15.2%, 95% confidence interval [CI] = 11.7 to 18.7); detailed PtDAs were somewhat more effective than simpler PtDAs (WMD = 4.6%, 95% CI = 3.0 to 6.2). PtDAs with probabilities improved accurate risk perceptions relative to those without probabilities (relative risk = 1.6, 95% CI = 1.4 to 1.9). Relative to simpler PtDAs, detailed PtDAs improved value congruence with the chosen option. Only 2 of 6 IPDAS decision process criteria were measured: feeling informed (15 trials) and feeling clear about values (13 trials). PtDAs improved these process measures relative to usual care (feeling uninformed WMD = —8.4, 95% CI = —11.9 to —4.8; unclear values WMD = —6.3, 95% CI = —10.0 to —2.7). There was no difference in process measures when detailed and simple PtDAs were compared. Conclusions. PtDAs improve decision quality and the decision process's measures of feeling informed and clear about values; however, the size of the effect varies across studies. Several IPDAS decision process measures have not been used. Future trials need to use a minimum data set of IPDAS evaluation measures. The degree of detail PtDAs require for positive effects on IPDAS criteria should be explored.

Suggested Citation

  • Annette M. O'Connor & Dawn Stacey & Michael J. Barry & Nananda F. Col & Karen B. Eden & Vikki Entwistle & Valerie Fiset & Margaret Holmes-Rovner & Sara Khangura & Hilary Llewellyn-Thomas & David R. Ro, 2007. "Do Patient Decision Aids Meet Effectiveness Criteria of the International Patient Decision Aid Standards Collaboration? A Systematic Review and Meta-analysis," Medical Decision Making, , vol. 27(5), pages 554-574, September.
    • Handle: RePEc:sae:medema:v:27:y:2007:i:5:p:554-574
    DOI: 10.1177/0272989X07307319
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    1. McBride, C.M. & Bastian, L.A. & Halabi, S. & Fish, L. & Lipkus, I.M. & Bosworth, H.B. & Rimer, B.K. & Siegler, I.C., 2002. "A tailored intervention to aid decisionmaking about hormone replacement therapy," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1112-1114.
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    Cited by:

    1. Sergey Motorny & Surendra Sarnikar & Cherie Noteboom, 2022. "Design of an Intelligent Patient Decision aid Based on Individual Decision-Making Styles and Information Need Preferences," Information Systems Frontiers, Springer, vol. 24(4), pages 1249-1264, August.
    2. Christopher E. Knoepke & Erin L. Chaussee & Daniel D. Matlock & Jocelyn S. Thompson & Colleen K. McIlvennan & Amrut V. Ambardekar & Elisabeth M. Schaffer & Prateeti Khazanie & Laura Scherer & Robert M, 2022. "Changes over Time in Patient Stated Values and Treatment Preferences Regarding Aggressive Therapies: Insights from the DECIDE-LVAD Trial," Medical Decision Making, , vol. 42(3), pages 404-414, April.
    3. Lyndal Trevena, 2021. "Commentary on History of IPDAS," Medical Decision Making, , vol. 41(7), pages 734-735, October.
    4. Angela Fagerlin & Karen R. Sepucha & Mick P. Couper & Carrie A. Levin & Eleanor Singer & Brian J. Zikmund-Fisher, 2010. "Patients’ Knowledge about 9 Common Health Conditions: The DECISIONS Survey," Medical Decision Making, , vol. 30(5_suppl), pages 35-52, September.
    5. Syahrir Zaini & Harvin Anbu Manivanna Bharathy & Ahmad Hatim Sulaiman & Jesjeet Singh Gill & Koh Ong Hui & Hasniza Zaman Huri & Siti Hadijah Shamsudin & Ng Chong Guan, 2018. "Development of a Strategic Tool for Shared Decision-Making in the Use of Antidepressants among Patients with Major Depressive Disorder: A Focus Group Study," IJERPH, MDPI, vol. 15(7), pages 1-12, July.
    6. Mary Ersek & Justine S. Sefcik & Feng-Chang Lin & Tae Joon Lee & Robin Gilliam & Laura C. Hanson, 2014. "Provider Staffing Effect on a Decision Aid Intervention," Clinical Nursing Research, , vol. 23(1), pages 36-53, February.
    7. France Légaré & Stéphane Turcotte & Dawn Stacey & Stéphane Ratté & Jennifer Kryworuchko & Ian Graham, 2012. "Patients’ Perceptions of Sharing in Decisions," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 5(1), pages 1-19, March.
    8. Stephen Auerbach, 2009. "The Impact on Patient Health Outcomes of Interventions Targeting the Patient-Physician Relationship," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 2(2), pages 77-84, June.
    9. Moumjid, Nora & Charles, Cathy & Morelle, Magali & Gafni, Amiram & Brémond, Alain & Farsi, Fadila & Whelan, Tim & Carrère, Marie-Odile, 2009. "The statutory duty of physicians to inform patients versus unmet patients' information needs: The case of breast cancer in France," Health Policy, Elsevier, vol. 91(2), pages 162-173, July.

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