570 Decision aids beneficial for people facing health treatment or screening decisions

April 19, 2018

written by Brian McAvoy

Clinical question

How effective are decision aids for people facing health treatment or screening decisions?

Bottom line

Compared with usual care across a wide variety of decision contexts, people exposed to decision aids felt more knowledgeable (high-quality evidence), better informed (high-quality evidence) and clearer about their values. They probably had a more active role in decision-making and more accurate risk perceptions (moderate-quality evidence). There were no adverse effects on health outcomes or satisfaction. There was improved knowledge and accurate risk perceptions when decision aids were used either within or in preparation for the consultation. Although knowledge scores and accurate risk perceptions were significantly higher in the decision-aid group compared with usual care, there was no difference in these outcomes when comparing decision aids used in preparation for, versus during, the consultation.

Caveat

The median effect of decision aids on length of consultation was 2.6 minutes longer (24 versus 21; 7.5% increase). The costs of the decision-aid group were lower in 2 studies and similar to usual care in 4 studies.

Context

Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values.

Cochrane Systematic Review

Stacey D et al. Decision aids for people facing health treatment or screening decisions. Cochrane Reviews, 2017, Issue 4. Art. No.: CD001431.DOI: 10.1002/14651858. CD001431.pub5. This review contains 105 studies involving 31,043 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.