Randomized Trial of a Decision Aid for Patients with Cystic Fibrosis Considering Lung Transplantation

Abstract

Use of a decision aid for patients with cystic fibrosis considering referral for lung transplantation, in addition to usual education and counseling, improves patient knowledge, realistic expectations, decisional conflict, and patient satisfaction. Clinical trial registered with www.clinicaltrials.gov (NCT00345449).

Decision Aids for Patients Facing a Surgical Treatment Decision

“…Patients were not blinded, as this is inherent to the intervention evaluated. Blinding of the care providers was impossible in some studies, 23,25,27,29,31,33 as they were involved in providing the decision aid. It was unclear whether outcome assessors were blinded to the intervention.…”

“…Twelve studies reported on the treatment options chosen by patients and their surgeons 19,21,[23][24][25][26][27]29,[31][32][33][34] A total of 473 of 1451 patients (33%) who had used a decision aid chose to undergo the invasive treatment option, whereas 539 of 1223 patients (44%) in the control groups made the same decision, resulting in an absolute difference of 11% and a risk ratio of 0.80 (95% CI, 0.67-0.95) (Fig. 3).…”

“…4). 18,20,22,27,28,31,33,34 Two studies that could not be included in the meta-analysis also reported significant differences in patient knowledge in favor of the decision aid group (P values < 0.001). 27,33 In another 2 studies, the knowledge test scores of patients who had been provided with a decision aid showed greater improvement over time.…”

Measuring patient-centered care: An updated systematic review of how studies define and report concordance between patients’ preferences and medical treatments

“…Twenty-six of the 61 studies involved a patient decision aid [16,18,20,22,25,32,33,[47][48][49][50][51][52][53]56,[58][59][60][61]64,66,68,[72][73][74][75]. Four additional studies reported using education materials such as educational sessions or pamphlets but did not refer to them as decision aids [17,43,63,70].…”

“…Thirty of the 61 studies reported assessment of the subjects' knowledge surrounding the decision [16,18,20,22,25,32,33,44,[47][48][49]51,53,[56][57][58][59][60][61][64][65][66]68,[71][72][73][74][75]77,78]. The majority of these studies (n = 27) used decision-specific items, while three [71,77,78] used generic measurements, e.g.…”