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Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis.

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Patient decision aids should include explicit values clarification methods to align choices with patient values. Multicriteria decision analysis may be particularly effective for improving values-congruent decisions.

Keywords:
decision makingpreference elicitationshared decision makingvalues clarification

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Area of Science:

  • Health Services Research
  • Decision Science
  • Medical Informatics

Background:

  • Patient decision aids aim to support evidence-informed choices aligned with individual values.
  • Guidance on achieving values alignment in patient decision aids is limited.

Purpose of the Study:

  • To identify and categorize values clarification methods for patient decision aids.
  • To synthesize evidence on the effectiveness of these methods.
  • To propose standardized outcomes for evaluating values clarification methods.

Main Methods:

  • Systematic review of randomized trials evaluating explicit values clarification methods.
  • Data extraction on method characteristics and evaluation outcomes.
  • Meta-analysis and synthesis of evidence.

Main Results:

  • Explicit values clarification methods reduced values-incongruent choices and decisional conflict compared to controls.
  • Multicriteria decision analysis demonstrated superior effectiveness in promoting values-congruent decisions.
  • No significant differences in decisional conflict were found between different explicit methods.

Conclusions:

  • Patient decision aids should incorporate explicit values clarification techniques.
  • Multicriteria decision analysis is a recommended method for enhancing values congruence.
  • Future research should standardize reporting on decisional conflict, decision outcomes, values congruence, and decisional regret.