Effect of a Decision Aid on Decision Making for the Treatment of Pelvic Organ Prolapse

Brazell, Hema D.; O’Sullivan, David; Forrest, Allison; Greene, John F.

doi:10.1097/spv.0000000000000149

Cited by 31 publications

(17 citation statements)

References 8 publications

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“…It is noted that 2 randomized studies focused on decision conflict showed no difference, 18, 23 and the remainder indicated that conflict decreased with use of SDM. However, all non-randomized studies that focused on decision conflict as a primary outcome found that decision conflict decreased with the introduction of SDM.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies 18, 20, 21, 23, 34, 39, 47, 50, 52, 54 were low risk of bias for random sequence allocation with one 51 having unknown risk of bias. For allocation concealment bias, 3 studies had unknown risk of bias 18, 23, 39 , with the remaining 8 having low risk of bias 20, 21, 34, 47, 50–54 . There was high risk of bias for blinding of participants and personnel in 8 studies which were not double-blinded 18, 20, 21, 23, 39, 47, 51, 53, 54 , with only 3 studies being blinded for either 2, 50, 52 .…”

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confidence: 99%

“…For allocation concealment bias, 3 studies had unknown risk of bias 18, 23, 39 , with the remaining 8 having low risk of bias 20, 21, 34, 47, 50–54 . There was high risk of bias for blinding of participants and personnel in 8 studies which were not double-blinded 18, 20, 21, 23, 39, 47, 51, 53, 54 , with only 3 studies being blinded for either 2, 50, 52 . Similarly for blinding of outcome assessment, 7 studies were not blinded 2, 18, 20, 23, 39, 47, 52–54 , 3 studies did not provide information on blinding 21, 51, 52 with only 1 study having blinding for outcome assessment 50 .…”

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confidence: 99%

“…There was high risk of bias for blinding of participants and personnel in 8 studies which were not double-blinded 18, 20, 21, 23, 39, 47, 51, 53, 54 , with only 3 studies being blinded for either 2, 50, 52 . Similarly for blinding of outcome assessment, 7 studies were not blinded 2, 18, 20, 23, 39, 47, 52–54 , 3 studies did not provide information on blinding 21, 51, 52 with only 1 study having blinding for outcome assessment 50 . Attrition bias was low across 10 of the included studies 18, 20, 21, 34, 39, 47, 50–54 with only 1 study having unknown dropout from the RCT 23 .…”

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confidence: 99%

“…Similarly for blinding of outcome assessment, 7 studies were not blinded 2, 18, 20, 23, 39, 47, 52–54 , 3 studies did not provide information on blinding 21, 51, 52 with only 1 study having blinding for outcome assessment 50 . Attrition bias was low across 10 of the included studies 18, 20, 21, 34, 39, 47, 50–54 with only 1 study having unknown dropout from the RCT 23 . For selective reporting, as most of the studies did not have a protocol, there was unknown risk of bias in 10 studies 18, 20, 21, 23, 34, 39, 47, 50, 51, 53, 54 , with only 1 study, which had a protocol and did not selectively report outcomes 52 .…”

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confidence: 99%

See 4 more Smart Citations

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

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Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.

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Section: Resultsmentioning

confidence: 99%