Decision aids for patients facing health treatment or screening decisions: systematic review
Decision aids for patients facing health treatment or screening decisions: systematic review
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DOI：
10.1136/bmj.319.7212.731
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发表时间：
1999-09-18
影响因子：
--
通讯作者：
Jones, J
中科院分区：
文献类型：
--
作者：
O'Connor, AM;Rostom, A;Jones, J
Objective To conduct a systematic review of randornised trials of patient decision aids in improving decision making and outcomes.Design我们纳入了随机干预试验，这些试验提供了有关治疗或筛查选项和结果的结构化、详细和具体信息，以帮助决策。两名评价者独立筛选并提取了几个评价标准的数据，结果通过加权平均差和相对风险进行汇总。结果17篇文献符合纳入标准。与控制组相比，决策辅助组的知识得分更高（加权平均差异= 19/100，95%置信区间14 - 25）;决策冲突评分较低（加权平均差= -0.3/5，-0.4至-0.1）;患者更积极地参与决策（相对危险度= 2.27，95%置信区间1.3 - 4）;焦虑、决策满意度（加权平均差异= 0.6/100，-3至4）或决策制造过程满意度（2/100，-3至7）无差异。决策辅助工具对决策的影响各不相同。当复杂的决策辅助相比，简单的版本，他们更好地减少决策冲突，提高知识边际，但不影响satisfaction.Conclusions决策辅助提高知识，减少决策冲突，刺激患者更积极的决策，而不增加他们的焦虑。决策辅助工具对满意度的影响很小，对决策的影响是可变的。对决策结果的影响（选择的持久性，生活质量）仍然不确定。
Objective To conduct a systematic review of randornised 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 malting 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.