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Evaluation of Shared Decision-Making Interventions in Pediatric Acute Care: A Systematic Review

Gemma Postill1,2, Francine Buchanan3, Sanjay Mahant3,4,5,6

  • 1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Hospital Pediatrics
|June 10, 2025
PubMed

Insights

Shared decision-making (SDM) interventions in pediatric acute care show promise, improving patient outcomes without increasing complications. Further research with standardized measures is recommended for broader application.

Area of Science:

  • Pediatric Acute Care
  • Health Services Research
  • Shared Decision-Making

Background:

  • Limited consensus exists on the effectiveness of shared decision-making (SDM) interventions in pediatric acute care.
  • Implementing SDM in urgent pediatric settings presents unique challenges.

Purpose of the Study:

  • To systematically review the effectiveness of SDM interventions in pediatric acute care settings.
  • To synthesize evidence on SDM's impact on patient-centered and clinical outcomes in children.

Main Methods:

  • Conducted a systematic review of multiple databases (MEDLINE, EMBASE, Cochrane, etc.) up to November 2024.
  • Included studies evaluating SDM interventions for acute medical problems in children (<19 years).
  • Extracted data on participants, study design, clinical decisions, and patient-centered/clinical outcomes.

Main Results:

  • 27 studies were included from 10,278 identified articles.
  • Interventions focused on conditions like respiratory infections, ICU decisions, head injuries, and appendicitis.
  • SDM interventions generally improved patient-centered and clinical outcomes without increasing resource use or complications.

Conclusions:

  • SDM interventions have been evaluated across various pediatric acute care scenarios.
  • Evidence suggests SDM improves patient outcomes and does not lead to increased complications.
  • Heterogeneity in interventions and outcome measures limited meta-analysis; standardized research is needed.
Abstract

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