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Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

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Summary

Computerized decision aids improve patient-centered outcomes in serious illness. However, the quality of these tools and study designs needs improvement for reliable results.

Keywords:
chronic diseasedecision aidsdecision makingevidence-based medicineuser-computer interface

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Area of Science:

  • Medical Informatics
  • Patient-Centered Care
  • Health Technology Assessment

Background:

  • Shared decision making (SDM) is crucial for patient-centered care.
  • Decision aids inform patients, reducing decisional conflict and aiding treatment choices.
  • Computerized decision aids offer a modern approach to enhancing SDM.

Purpose of the Study:

  • To systematically review the impact of computerized decision aids on patient-centered outcomes for seriously ill patients.
  • To assess the role of these tools in facilitating shared decision making in serious illness.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) from PubMed and Scopus.
  • Included studies focused on computerized decision aids, patient-centered outcomes, and SDM in serious illness.
  • Risk of bias was assessed using a modified Cochrane tool.

Main Results:

  • Six RCTs evaluated computerized decision aids across various serious illnesses.
  • Most studies showed improvements in at least one patient-centered outcome.
  • Computerized tools may reduce unnecessary treatments and enhance patient satisfaction, potentially without increased physician involvement.

Conclusions:

  • Computerized decision aids generally enhance patient-centered outcomes in serious illness.
  • A significant limitation is the high or unclear risk of bias in identified RCTs.
  • Future research should prioritize higher-quality RCTs to validate the effectiveness of SDM aids.