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Shared Decision Making in Pediatrics: A Systematic Review and Meta-analysis

Kirk D Wyatt1, Betsy List2, William B Brinkman3

  • 1Pediatric and Adolescent Medicine Residency Program, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, Minn; Mayo Medical School, Mayo Clinic, Rochester, Minn; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minn.

Academic Pediatrics
|May 19, 2015
PubMed

Insights

Shared decision making (SDM) interventions in pediatrics significantly improve patient knowledge and reduce decisional conflict. However, their impact on satisfaction remains unclear, indicating a need for further research.

Area of Science:

  • Pediatric Healthcare Research
  • Clinical Decision Making
  • Evidence Synthesis

Background:

  • Limited understanding of shared decision making (SDM) interventions' impact on pediatric patients.
  • Need to evaluate patient-centered outcomes in pediatric healthcare.

Purpose of the Study:

  • To systematically review and summarize the efficacy of SDM interventions in pediatrics.
  • To assess the impact of SDM interventions on patient-centered outcomes.

Main Methods:

  • Comprehensive literature search across multiple databases (Ovid Medline, Embase, Cochrane Library, Web of Science, Scopus, PsycInfo) up to December 2013.
  • Inclusion of studies engaging pediatric patients and/or parents in medical decisions.
  • Meta-analysis conducted on knowledge, decisional conflict, and satisfaction outcomes.

Main Results:

  • 54 interventions from 61 citations were included; 15 were eligible for meta-analysis.
  • SDM interventions significantly improved patient knowledge (SMD 1.21) and reduced decisional conflict (SMD -1.20).
  • A non-significant trend towards increased patient satisfaction was observed (SMD 0.37).

Conclusions:

  • Pediatric SDM interventions effectively enhance patient knowledge and decrease decisional conflict.
  • The evidence base for SDM interventions in pediatrics is limited and heterogeneous.
  • Further research is needed to clarify the impact of SDM on other patient-centered outcomes.
Abstract

Keywords:
adolescentchildchild, preschooldecision aidsdecision makingdecision making, shareddecision support techniquesinfantinfant, newbornpediatrics

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