Randomized Trial of a Portable, Self-administered Decision Aid for Postmenopausal Women Considering Long-term Preventive Hormone Therapy

Abstract

Although practice guidelines suggest that postmenopausal women learn about the benefits and risks and consider their values when deciding about hormone therapy, the optimal decision-support method has not been established. In a randomized controlled trial, the authors compared the efficacy of a general educational pamphlet with that of a tailored decision aid. The pamphlet briefly summarized benefits, risks, and likely beneficiaries in general terms. The decision aid, delivered via booklet and audiotape, provided: detailed benefits and risks using functional terms and probabilities tailored to clinical risk; and steps for considering the issue in a woman's own situation, including a value-clarification exercise. Compared with the pamphlet group, the decision-aid group had statistically significant (p < 0.05) improvements in terms of realistic personal expectations of the benefits and risks, decisional conflict, and perceived acceptability of the intervention. Levels of general knowledge about the main benefits and risks were comparable for the two interventions. It is concluded that tailored decision aids prepare women for decision making better than do general pamphlets.

Development and evaluation of a patient decision aid for young people and parents considering fixed orthodontic appliances

“…According to the Decisional Conflict Scale users-manual a total score of 25 or lower is associated with implementing a decision . This indicates that participants were more likely to make a decision following use of the FADA; however, the mean total score of the participants at baseline was lower than the minimum threshold of 38 which is associated with delay in decision making (O'Connor et al, 1998).…”

Radial Artery Versus Femoral Artery Access Options in Coronary Angiogram Procedures

“…Finally, decisional conflict can increase the likelihood of patients to blame their physician for bad outcomes. 16,17 Adjusted analysis, accounting for significant differences in baseline characteristics between the 2 groups, demonstrate that the vascular access PtDA no longer significantly predicts the outcome (DCS); however, the reduction in decisional conflict in patients receiving the vascular access PtDA was consistent with trials of other PtDAs. 15,18 Therefore, its benefits cannot be discounted, but further studies are required.…”

A randomized trial of a breast/ovarian cancer genetic testing decision aid used as a communication aid during genetic counseling

“…We therefore developed a decision aid designed specifically for Australian women considering genetic testing for breast/ovarian cancer risk, using the theoretical frameworks developed by O'Connor and colleagues [3,14,15]. The topics in the 40-page decision aid include background information about cancer and cancer-related genes, a description of the testing process, possible test results and a discussion of the potential impact of testing on the individual and their family.…”

“…The low literacy version includes 10 items and assesses four subscales. These include: the informed subscale (which assesses perceived knowledge or feeling informed about the available options and potential outcomes of these options); the values clarity subscale (which assesses unclear values, or being unable to define which outcomes are personally important to the decision maker); the support subscale (which assesses perceived emotional or practical support from others); and the uncertainty subscale (which assesses feelings of uncertainty about what is the right decision for the decision maker) [14]. (4) Knowledge of genetic testing: Eight true-false items were purposively designed for this study [16].…”