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Effects of Decision Support Interventions on Treatment Decision-Making in Patients With Prostate Cancer: A Systematic
Yue Wen1, Yanqiu Li1, Suhua Zheng2
1School of Medical and Health Engineering, Changzhou University, Changzhou, Jiangsu, China.
Purpose:
To compare the effectiveness of decision support interventions on treatment decision-making outcomes among men with prostate cancer.
Methods:
A systematic review of randomized controlled trials was conducted. Electronic databases were searched from inception to March 2026. Eligible studies evaluated decision support interventions delivered during the prostate cancer treatment decision-making phase, including booklet-based, digital, and multimodal formats. The primary outcome was decision conflict. Secondary outcomes included decision regret, knowledge, decision readiness, and psychological distress. Bayesian network meta-analysis and conventional pairwise meta-analysis were used to compare intervention effects.
Results:
Thirteen randomized controlled trials were included. Decision support interventions were categorized into three types: booklet-based, digital, and multimodal interventions. Network meta-analysis showed that booklet-based interventions reduced decision conflict (SMD = -0.98, 95% CI -1.60 to -0.24). No statistically significant effects were observed for decision regret or knowledge level. Pairwise meta-analysis showed that decision support interventions improved decision readiness but had limited effects on psychological distress.
Conclusions:
Decision support interventions showed outcome-specific effects in patients with prostate cancer facing treatment decisions, with booklet-based interventions providing the clearest signal for reducing decision conflict and overall interventions improving decision readiness. These findings support further evaluation of accessible, low-burden, and age-friendly decision support formats in prostate cancer treatment decision-making.
