Decision aids: are they worth it? A systematic review.
Decision aids: are they worth it? A systematic review.
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DOI：
10.1258/1355819011927431
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发表时间：
2001-07-01
影响因子：
2.4
通讯作者：
Williams, I
中科院分区：
文献类型：
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作者：
Estabrooks, C;Goel, V;Williams, I
目的：在过去的20年里，消费者决策支持干预领域迅速发展，特别是自从医疗保健中基于证据的决策越来越正规化以来。然而，很少有人知道这些决策辅助工具对相关结果的影响。为了确定结果的影响，消费者决策援助（CDAs）和CDAs对这些outcome.METHOD的特殊影响：随机对照试验和其他设计的英文发表报告确定从搜索的Medline，Cancerlit，CINAHL，PsycINFO，社会科学摘要，科克伦图书馆和当前的内容，并从祖先搜索，手搜索和咨询的关键线人。如果消费者是决策者，决策是真实的而不是假设的，干预符合CDA的严格定义，决策涉及治疗或筛查，则纳入研究。数据设置，主题，决策类型，决策辅助功能和结果进行了提取。每项研究的有效性由两名团队成员进行评估。结果：初步评估了500多个标题，获得96份研究报告，并筛选纳入。代表20项研究的22份报告符合纳入标准。排除了8项评分较低的研究。结果是从其余12项研究中综合得出的。已发表的CDA研究正在增加，尽管数量仍然很少。诸如知识和决策过程等结果受到CDA的影响，但对治疗偏好、实际决策或其他结果的影响尚未明确。在某些类别的结局中使用CDA可改善结局，但尚未有足够的证据支持所有类别的结局改善，或者考虑到许多CDA的相当大的成本，可以持续为正在进行的广泛开发和测试提供资金。
OBJECTIVES: The field of consumer decision support interventions has grown rapidly in the last 20 years, particularly since the increased formalization of evidence-based decision-making in health care. However, little is known as yet about the effect these decision aids have on relevant outcomes. To identify outcomes influenced by consumer decision aids (CDAs) and the particular effects of CDAs on those outcomes.METHOD: Published reports of randomized controlled trials and other designs in English identified from searches of Medline, Cancerlit, CINAHL, PsycINFO, Social Science Abstracts, the Cochrane Library and Current Contents, and from ancestry searches, hand searches and consultation with key informants. Studies were included if consumers were the decision-makers, decisions were real and not hypothetical, the intervention met a strict definition of a CDA and decisions involved treatment or screening. Data on setting, subjects, decision types, decision aid features and outcomes were extracted. The validity of each study included was evaluated by two team members. Summative ratings were calculated and categorized as high, medium and low.RESULTS: Over 500 titles were initially assessed; 96 study reports were obtained and screened for inclusion. Twenty-two reports representing 20 studies met the inclusion criteria. Eight studies with a low rating were excluded. Results were synthesized from the remaining 12 studies. Published studies of CDAs are increasing although still few in number. Outcomes such as knowledge and decision-making processes are influenced by CDAs but effects on treatment preferences, the actual decision or other outcomes have yet to be clearly established.CONCLUSIONS: Improved outcomes result from the use of CDA in some categories of outcome but insufficient evidence exists yet to support improved outcomes in all categories or to evaluate whether, given the considerable costs of many CDAs, funding for extensive ongoing development and testing can be sustained.