Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis

Annette M. O'Connor, Carol Bennett, Dawn Stacey, Michael J. Barry, Nananda F. Col, Karen Eden, Vikki Entwistle, Valerie Fiset, Margaret Holmes-Rovner, Sara Khangura, Hilary Llewellyn-Thomas, David R. Rovner

Research output: Contribution to journalArticle

191 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)554-574
Number of pages21
JournalMedical Decision Making
Volume27
Issue number5
DOIs
StatePublished - Sep 2007

Fingerprint

Decision Support Techniques
Meta-Analysis
Process Assessment (Health Care)
Confidence Intervals
Emotions
Information Storage and Retrieval

Keywords

  • Decision support techniques
  • Patient education
  • Patient participation
  • Randomized controlled trials

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Informatics
  • Health Information Management
  • Nursing(all)

Cite this

Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis. / O'Connor, Annette M.; Bennett, Carol; Stacey, Dawn; Barry, Michael J.; Col, Nananda F.; Eden, Karen; Entwistle, Vikki; Fiset, Valerie; Holmes-Rovner, Margaret; Khangura, Sara; Llewellyn-Thomas, Hilary; Rovner, David R.

In: Medical Decision Making, Vol. 27, No. 5, 09.2007, p. 554-574.

Research output: Contribution to journalArticle

O'Connor, AM, Bennett, C, Stacey, D, Barry, MJ, Col, NF, Eden, K, Entwistle, V, Fiset, V, Holmes-Rovner, M, Khangura, S, Llewellyn-Thomas, H & Rovner, DR 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, no. 5, pp. 554-574. https://doi.org/10.1177/0272989X07307319
O'Connor, Annette M. ; Bennett, Carol ; Stacey, Dawn ; Barry, Michael J. ; Col, Nananda F. ; Eden, Karen ; Entwistle, Vikki ; Fiset, Valerie ; Holmes-Rovner, Margaret ; Khangura, Sara ; Llewellyn-Thomas, Hilary ; Rovner, David R. / Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis. In: Medical Decision Making. 2007 ; Vol. 27, No. 5. pp. 554-574.
@article{e17fe207d0564dcbbdf0a950bf552a85,
title = "Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis",
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.",
keywords = "Decision support techniques, Patient education, Patient participation, Randomized controlled trials",
author = "O'Connor, {Annette M.} and Carol Bennett and Dawn Stacey and Barry, {Michael J.} and Col, {Nananda F.} and Karen Eden and Vikki Entwistle and Valerie Fiset and Margaret Holmes-Rovner and Sara Khangura and Hilary Llewellyn-Thomas and Rovner, {David R.}",
year = "2007",
month = "9",
doi = "10.1177/0272989X07307319",
language = "English (US)",
volume = "27",
pages = "554--574",
journal = "Medical decision making : an international journal of the Society for Medical Decision Making",
issn = "0272-989X",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis

AU - O'Connor, Annette M.

AU - Bennett, Carol

AU - Stacey, Dawn

AU - Barry, Michael J.

AU - Col, Nananda F.

AU - Eden, Karen

AU - Entwistle, Vikki

AU - Fiset, Valerie

AU - Holmes-Rovner, Margaret

AU - Khangura, Sara

AU - Llewellyn-Thomas, Hilary

AU - Rovner, David R.

PY - 2007/9

Y1 - 2007/9

N2 - 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.

AB - 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.

KW - Decision support techniques

KW - Patient education

KW - Patient participation

KW - Randomized controlled trials

UR - http://www.scopus.com/inward/record.url?scp=35148879488&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35148879488&partnerID=8YFLogxK

U2 - 10.1177/0272989X07307319

DO - 10.1177/0272989X07307319

M3 - Article

C2 - 17873255

AN - SCOPUS:35148879488

VL - 27

SP - 554

EP - 574

JO - Medical decision making : an international journal of the Society for Medical Decision Making

JF - Medical decision making : an international journal of the Society for Medical Decision Making

SN - 0272-989X

IS - 5

ER -