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Where is the theory? Evaluating the theoretical frameworks described in decision support technologies
Marie-Anne Durand1, Mareike Stiel, Jacky Boivin
1Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
Patient Education and Counseling
|February 5, 2008
Summary
Theory rarely informs decision support technologies (DSTs), with most lacking explicit guidance on design and evaluation. More attention is needed to integrate decision-making theories into DST development for better patient outcomes.
Area of Science:
- Health Informatics
- Decision Science
- Human-Computer Interaction
Background:
- Decision support technologies (DSTs) aid individuals in making health choices.
- The rigorous development of DSTs is crucial for effective patient decision-making.
- Understanding the theoretical underpinnings of DSTs is essential for their advancement.
Purpose of the Study:
- To assess the extent to which theoretical frameworks inform the development and evaluation of DSTs.
- To identify the specific theories used in DST design and their application.
- To evaluate the explicitness and depth of theoretical integration in DSTs.
Main Methods:
- Analysis of DSTs included in the Cochrane systematic review of patient decision aids.
- Focus on DSTs evaluated through randomized controlled trials for rigorous development.
- Examination of the described theoretical frameworks and their influence on DST design and evaluation.
Main Results:
- Only 34% (17 of 50) of evaluated DSTs were based on a theoretical framework.
- Eleven distinct decision-making theories were identified, but their application varied significantly.
- Most DSTs lacked explicit descriptions of how theory guided their design, with many having superficial theoretical integration.
- None of the DSTs reported field-testing prior to their evaluation.
Conclusions:
- The integration of decision-making theory in DST development is infrequent and inadequately described.
- The nascent stage of the DST field likely contributes to the limited theoretical grounding.
- There is a clear need to enhance the utilization of decision-making theories to guide DST design and functional components.
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