Problem with patient decision aids

Published on Aug 1, 2021
· DOI :10.1136/BMJEBM-2020-111371
Joshua R. Zadro10
Estimated H-index: 10
(USYD: University of Sydney),
Adrian C Traeger18
Estimated H-index: 18
(USYD: University of Sydney)
+ 1 AuthorsMary O'Keeffe21
Estimated H-index: 21
Sources
Abstract
: Patient decision aids are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. Research shows that patient decision aids increase knowledge, accuracy of risk perceptions, alignment of care with patient values and preferences, and patient involvement in decision making. Some patient decision aids can reduce the use of invasive and potentially low-value procedures. On this basis, clinical practice guidelines and international organisations have begun to recommend the use of patient decision aids and shared decision making as a strategy to reduce medical overuse. Although patient decision aids hold promise for improving healthcare, there are fundamental issues with patient decision aids that need to be addressed before further progress can be made. The problems with patient decision aids are: (1) Guidelines for developing patient decision aids may not be sufficient to ensure developers select the best available evidence and present it appropriately; (2) Biased presentation of low-certainty evidence is common and (3) Biased presentation of low-certainty evidence is misleading, and could inadvertently support, low-value care. We explore these issues in the article and present a case study of online patient decision aids for musculoskeletal pain. We suggest ways to ensure patient decision aids help patients understand the evidence and, where possible, support high-quality care.
📖 Papers frequently viewed together
References23
Newest
Summary This is the first article in a series on “Overcoming Overuse” in musculoskeletal health care. Overuse is the use of services that are unlikely to improve patient outcomes, result in more ha...
Source
OBJECTIVE: To develop an evidence-based guideline for the comprehensive management of osteoarthritis (OA) as a collaboration between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA. METHODS: We identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review Team performed a systematic literature review to summarize ev...
Source
#1Vanessa B Hurley (Georgetown University)H-Index: 4
#2Hector P. Rodriguez (University of California, Berkeley)H-Index: 33
Last. Stephen M. Shortell (Graduate School USA)H-Index: 92
view all 6 authors...
Trials of decision aids developed for use in shared decision making find that patients engaged in that process tend to choose more conservative treatment for preference-sensitive conditions. Shared...
Source
#1Guillaume DevilleH-Index: 1
#2Jo Gibson (RLUH: Royal Liverpool University Hospital)H-Index: 4
Last. Matthieu Guemann (University of Bordeaux)H-Index: 2
view all 4 authors...
Resume Objectif Le but de cet article etait de synthetiser les resultats de recherche qui explorent les options de traitement pour les personnes souffrant d’une douleur d’epaule associee a une dechirure non traumatique de la coiffe des rotateurs, puis d’utiliser ces informations pour developper un outil d’aide aux patients pour la prise de decision therapeutique. Methodes Une revue de litterature a ete entreprise pour identifier les facteurs susceptibles d’influencer les choix de traitement qui ...
Source
#1Teemu Karjalainen (Monash University)H-Index: 4
#2Nitin B. Jain (Vandy: Vanderbilt University)H-Index: 8
Last. Rachelle Buchbinder (Monash University)H-Index: 123
view all 6 authors...
BACKGROUND: This review is one in a series of Cochrane Reviews of interventions for shoulder disorders. OBJECTIVES: To synthesise the available evidence regarding the benefits and harms of rotator cuff repair with or without subacromial decompression in the treatment of rotator cuff tears of the shoulder. SEARCH METHODS: We searched the CENTRAL, MEDLINE, Embase, Clinicaltrials.gov and WHO ICRTP registry unrestricted by date or language until 8 January 2019. SELECTION CRITERIA: Randomised control...
Source
#1Mary Catherine Beach (Johns Hopkins University)H-Index: 59
#2Jeremy Sugarman (Johns Hopkins University)H-Index: 68
Source
#1Michael Anthony Fajardo (USYD: University of Sydney)H-Index: 6
#2Bandar Durayb (USYD: University of Sydney)H-Index: 1
Last. Carissa Bonner (USYD: University of Sydney)H-Index: 23
view all 6 authors...
Background. Musculoskeletal conditions are leading causes of disability. Management options are plentiful, but the current evidence base suggests many are ineffective or unproven. Online decision aids can help support patients make informed health care choices. However, there are little data on the quality of online decision aids for common musculoskeletal conditions such as knee or low back pain. Purpose. To identify all publicly available online decision aids for knee osteoarthritis and low ba...
Source
#1Teemu Karjalainen (Monash University)H-Index: 4
#2Nitin B. Jain (Vandy: Vanderbilt University)H-Index: 8
Last. Rachelle Buchbinder (Monash University)H-Index: 123
view all 11 authors...
BACKGROUND: Surgery for rotator cuff disease is usually used after non-operative interventions have failed, although our Cochrane Review, first published in 2007, found that there was uncertain clinical benefit following subacromial decompression surgery. OBJECTIVES: To synthesise the available evidence of the benefits and harms of subacromial decompression surgery compared with placebo, no intervention or non-surgical interventions in people with rotator cuff disease (excluding full thickness r...
Source
#5Luca Ronfani (Mario Negri Institute for Pharmacological Research)H-Index: 73
#6Ettore BeghiH-Index: 99
Last. Norberto Perico (Mario Negri Institute for Pharmacological Research)H-Index: 95
view all 990 authors...
Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, St Jude Children’s Research Hospital, the National Institute on Ageing of the National Institutes of Health (award P30AG047845), and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163).
Source
#1Kimberly Wintemute (U of T: University of Toronto)H-Index: 6
#2Lynn Wilson (U of T: University of Toronto)H-Index: 15
Last. Wendy Levinson (U of T: University of Toronto)H-Index: 79
view all 3 authors...
At the core of the Choosing Wisely Canada (CWC) campaign is the commitment to engaging clinicians and patients in conversations about unnecessary tests and treatments. As of April 2018, the campaign is 4 years old, and important milestones have been achieved. Recommendations have been developed and
Cited By3
Newest
#1Joshua R. Zadro (USYD: University of Sydney)H-Index: 10
#2Caitlin Jones (USYD: University of Sydney)H-Index: 2
Last. Christopher G. Maher (USYD: University of Sydney)H-Index: 147
view all 11 authors...
Objective null To develop and user test a patient decision aid for people with subacromial pain syndrome that presents evidence-based information on the benefits and harms of subacromial decompression surgery and rotator cuff repair surgery. null Design null Mixed-methods study outlining the development of a patient decision aid. null Setting null We assembled a multidisciplinary steering group, and used existing decision aids and decision science to draft the decision aid. Participants were rec...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.