Basing Information on Comprehensive, Critically Appraised, and Up-to-Date Syntheses of the Scientific Evidence: An Update from the International Patient Decision Aid Standards

Abstract

Background Patients and clinicians expect the information in patient decision aids to be based on the best available research evidence. The objectives of this International Patient Decision Aid Standards (IPDAS) review were to 1) check the currency of, and where needed, update evidence for the domain of “basing the information in decision aids on comprehensive, critically appraised, and up-to-date syntheses of the evidence”; 2) analyze the evidence characteristics of decision aids; and 3) propose updates to relevant IPDAS criteria. Methods We searched MEDLINE and PubMed to inform updates of this domain’s definitions, justifications, and components. We also searched 5 sources to identify all publicly available decision aids ( N = 471). Two assessors independently extracted each aid’s evidence characteristics. Results Minor updates to the definitions and theoretical justifications of this IPDAS domain are provided and changes to relevant IPDAS criteria proposed. Nearly all aids (97%) provided a year of creation/update, but most (81%) did not report an explicit update or expiration policy. No scientific references were cited in 33% of aids. Of the 314 that cited at least 1 reference, 39% cited at least 1 guideline, 44% cited at least 1 systematic review, and 23% cited at least 1 randomized trial. In 35%, it was unclear what statement in the aid the citations referred to. Only 14% reported any of the processes used to find and decide on evidence inclusion. Only 14% reported the evidence quality. Many emerging issues and future research areas were identified. Conclusions Although many emerging issues need to be addressed, this IPDAS domain is validated and criteria refined. High-quality patient decision aids should be based on comprehensive and up-to-date syntheses of critically appraised evidence.

A scattered landscape: assessment of the evidence base for 71 patient decision aids developed in a hospital setting

“…However, instead of leaving patients without any information, or completely skip SDM in favor of a decision by the physician, the available evidence—in our view—should be presented to patients in a transparent way including information on evidence quality and confidence in findings. This is also in line with recent findings from an IPDAS review group [ 11 ]. We are uncertain whether we always succeeded in our attempt to transparently report on the pros and cons of treatment alternatives without causing patients to be more uncertain after reading our decision aid than before.…”

“…Several recent reviews of published PtDAs suggest a lack of well documented evidence review and summarization processes [ 11 , 12 , 24 ]. In contrast, we consider our evidence reviews comprehensive and well documented.…”

“…In our PtDA development process, the International Patient Decision Aids Standards (IPDAS) [ 8 – 10 ] were consistently and carefully observed. A recent review of IPDAS criteria by Hoffman et al 2021 on the domain of “basing the information in decision aids on comprehensive, critically appraised, and up-to-date syntheses of the evidence’’ included a review of the evidence base of 471 decision aids [ 11 ]. This review revealed that 33% of PtDAs did not report any references to the scientific evidence used, despite being recommended by IPDAS.…”

“…Moreover, researchers in the field have recently been requesting more standardized review and evidence summarization processes for the development of PtDAs [ 12 – 14 ]. Also, the recent revisions to the IPDAS “quality criteria” on the inclusion of evidence in PtDAs state, e.g., that in the absence of high-quality systematic reviews, best available evidence should be searched for and appraised instead [ 11 , 15 ].…”

Development of a Decision Support Tool for Acute Appendicitis

“…(11) We also outline how the tool complies with the International Patient Decision Aid Standards (IPDAS) guideliens for a patient decision aid. (12,13)…”