scholarly journals Evaluating the acceptability of an online patient decision aid for the surgical management of lower urinary tract symptoms secondary to benign prostatic hyperplasia

2021 ◽  
Vol 15 (8) ◽  
pp. 247-54
Author(s):  
David Bouhadana ◽  
David-Dan Nguyen ◽  
Brendan Raizenne ◽  
Joe Schwarcz ◽  
Harvey Gordon ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Decision Aid ◽  
Decision Aids ◽  
Prostatic Hyperplasia ◽  
Patient Decision Aid ◽  
Management Options ◽  
Amount Of Information ◽  
Patient Decision ◽  
Surgical Options ◽  
Endoscopic Enucleation

Introduction: The growing number of surgical options available to treat benign prostatic hyperplasia (BPH), may overwhelm patients and urologists when deciding on an optimal treatment. Therefore, we developed an online patient decision aid (PtDA) that includes all guideline-approved surgical modalities. The objective of this study was to assess the acceptability of the PtDA among former BPH surgery patients and urologists that treat BPH surgically. Methods: The International Patient Decision Aids Standards were used to develop a PtDA that includes monopolar transurethral resection of the prostate (TURP), bipolar TURP, GreenLight photovaporization, endoscopic enucleation of the prostate, Rezum, Urolift, Aquablation, open retropubic prostatectomy, and robotic simple prostatectomy as management options. Eleven urologists that regularly treat BPH and 19 patients who received BPH surgery were recruited. Alpha-testing was performed using a validated acceptability scoring system. Results: For all sections of the PtDA, most urologists agreed that the language used was easy to follow (91.9%), that the amount of information provided was adequate (63.6%), that the length of the PtDA was appropriate (63.6%), and that the outcomes reported were correct (81.8%). All 19 patient participants agreed that the language used was easy to follow, and most found that the amount of information provided was adequate (84.2%), that the length of the PtDA was appropriate (84.2%), and that the outcomes reported were well-explained (89.5%). Conclusions: Our PtDA was found to be acceptable among urologists and patients. These results demonstrate that most of the participants either recommend the use of this tool or plan to incorporate it in their clinical practice.

Management Patterns for Benign Prostatic Hyperplasia: Impact of a Patient Decision Aid

2021 ◽  
Vol 8 (4) ◽  
pp. 523-528
Author(s):  
Joshua E. Sadik ◽  
Sylvia Lambrechts ◽  
Lorna Kwan ◽  
Hui Liu ◽  
Joseph Shirk ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Decision Aid ◽  
Prostatic Hyperplasia ◽  
Patient Decision Aid ◽  
Patient Decision

scholarly journals Systematic Development of Patient Decision Aids: An Update from the IPDAS Collaboration

2021 ◽  
pp. 0272989X2110141
Author(s):  
Holly O. Witteman ◽  
Kristin G. Maki ◽  
Gratianne Vaisson ◽  
Jeanette Finderup ◽  
Krystina B. Lewis ◽  
...  
Keyword(s):  
Decision Aid ◽  
Decision Aids ◽  
Rapid Development ◽  
User Involvement ◽  
User Centered Design ◽  
Patient Decision Aid ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Development Processes ◽  
Systematic Development

Background The 2013 update of the evidence informing the quality dimensions behind the International Patient Decision Aid Standards (IPDAS) offered a model process for developers of patient decision aids. Objective To summarize and update the evidence used to inform the systematic development of patient decision aids from the IPDAS Collaboration. Methods To provide further details about design and development methods, we summarized findings from a subgroup ( n = 283 patient decision aid projects) in a recent systematic review of user involvement by Vaisson et al. Using a new measure of user-centeredness (UCD-11), we then rated the degree of user-centeredness reported in 66 articles describing patient decision aid development and citing the 2013 IPDAS update on systematic development. We contacted the 66 articles’ authors to request their self-reports of UCD-11 items. Results The 283 development processes varied substantially from minimal iteration cycles to more complex processes, with multiple iterations, needs assessments, and extensive involvement of end users. We summarized minimal, medium, and maximal processes from the data. Authors of 54 of 66 articles (82%) provided self-reported UCD-11 ratings. Self-reported scores were significantly higher than reviewer ratings (reviewers: mean [SD] = 6.45 [3.10]; authors: mean [SD] = 9.62 [1.16], P < 0.001). Conclusions Decision aid developers have embraced principles of user-centered design in the development of patient decision aids while also underreporting aspects of user involvement in publications about their tools. Templates may reduce the need for extensive development, and new approaches for rapid development of aids have been proposed when a more detailed approach is not feasible. We provide empirically derived benchmark processes and a reporting checklist to support developers in more fully describing their development processes. [Box: see text]

scholarly journals Basing Information on Comprehensive, Critically Appraised, and Up-to-Date Syntheses of the Scientific Evidence: An Update from the International Patient Decision Aid Standards

2021 ◽  
pp. 0272989X2199662
Author(s):  
Tammy C. Hoffmann ◽  
Mina Bakhit ◽  
Marie-Anne Durand ◽  
Lilisbeth Perestelo-Pérez ◽  
Catherine Saunders ◽  
...  
Keyword(s):  
Decision Aid ◽  
Scientific Evidence ◽  
Decision Aids ◽  
Future Research ◽  
Patient Decision Aid ◽  
Patient Decision Aids ◽  
Research Areas ◽  
Patient Decision ◽  
Evidence Quality ◽  
Emerging Issues

Background Patients and clinicians expect the information in patient decision aids to be based on the best available research evidence. The objectives of this International Patient Decision Aid Standards (IPDAS) review were to 1) check the currency of, and where needed, update evidence for the domain of “basing the information in decision aids on comprehensive, critically appraised, and up-to-date syntheses of the evidence”; 2) analyze the evidence characteristics of decision aids; and 3) propose updates to relevant IPDAS criteria. Methods We searched MEDLINE and PubMed to inform updates of this domain’s definitions, justifications, and components. We also searched 5 sources to identify all publicly available decision aids ( N = 471). Two assessors independently extracted each aid’s evidence characteristics. Results Minor updates to the definitions and theoretical justifications of this IPDAS domain are provided and changes to relevant IPDAS criteria proposed. Nearly all aids (97%) provided a year of creation/update, but most (81%) did not report an explicit update or expiration policy. No scientific references were cited in 33% of aids. Of the 314 that cited at least 1 reference, 39% cited at least 1 guideline, 44% cited at least 1 systematic review, and 23% cited at least 1 randomized trial. In 35%, it was unclear what statement in the aid the citations referred to. Only 14% reported any of the processes used to find and decide on evidence inclusion. Only 14% reported the evidence quality. Many emerging issues and future research areas were identified. Conclusions Although many emerging issues need to be addressed, this IPDAS domain is validated and criteria refined. High-quality patient decision aids should be based on comprehensive and up-to-date syntheses of critically appraised evidence.

scholarly journals Developing a web-based patient decision aid for gastrostomy in motor neuron disease: a study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032364
Author(s):  
Rose Maunsell ◽  
Suzanne Bloomfield ◽  
Clare Erridge ◽  
Claire Foster ◽  
Maggi Hardcastle ◽  
...  
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Decision Aid ◽  
Decision Aids ◽  
Phase 1 ◽  
Second Phase ◽  
Patient Decision Aid ◽  
Two Phase ◽  
Patient Decision ◽  
Academic Publications

IntroductionMotor neuron disease (MND) is a progressive, incurable disease, characterised by degeneration of the nerves in the brain and spinal cord. Due to the multisystem effects of the disease, patients are faced with many complex, time-sensitive decisions, one of which is the decision on gastrostomy feeding. There are currently no published decision aids (DAs) to support patients making this decision in the UK. This study will develop and pilot a patient DA to provide evidence-based information on gastrostomy placement and feeding that is relevant to people with MND; communicate the risks and benefits associated with each option; check understanding and clarify personal values and preferences, enabling patients to make a decision congruent with their values and appropriate for them.Methods and analysisA two-phase process, observing the International Patient Decision Aid Standards, will be used to develop the DA, over 24 months starting January 2019. Phase 1 will use literature reviews and stakeholder interviews and surveys to identify essential content for the DA, and explore the best way to present this. In the second phase, a prototype DA will be developed and revised using stakeholder feedback in an iterative process. Stakeholders will include individuals with MND, their carers and the healthcare professionals working with them.Ethics and disseminationEthical approval for the study has been granted by West of Scotland Research Ethics Service, reference 19/WS/0078. Study findings will be disseminated through academic and non-academic publications, conference presentations, stakeholder websites and social media. A feasibility study will follow to explore the acceptability and practicality of the DA for patients, carers and HCPs in practice and to assess whether the DA shows promise of being beneficial for the intended population.

Do Patient Decision Aids Meet Effectiveness Criteria of the International Patient Decision Aid Standards Collaboration? A Systematic Review and Meta-analysis

2007 ◽  
Vol 27 (5) ◽  
pp. 554-574 ◽  
Author(s):  
Annette M. O'Connor ◽  
Dawn Stacey ◽  
Michael J. Barry ◽  
Nananda F. Col ◽  
Karen B. Eden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Aid ◽  
Meta Analysis ◽  
Decision Aids ◽  
Patient Decision Aid ◽  
Patient Decision Aids ◽  
Patient Decision

What Is the Effectiveness of Patient Decision Aids for Cancer-Related Decisions? A Systematic Review Subanalysis

2018 ◽  
pp. 1-13 ◽  
Author(s):  
Kristen McAlpine ◽  
Krystina B. Lewis ◽  
Lyndal J. Trevena ◽  
Dawn Stacey
Keyword(s):  
Decision Making ◽  
Cancer Screening ◽  
Decision Aid ◽  
Weighted Mean Difference ◽  
Decision Aids ◽  
Decision Making Process ◽  
Patient Decision Aid ◽  
Weighted Mean ◽  
Patient Decision Aids ◽  
Patient Decision

Purpose To determine the effectiveness of patient decision aids when used with patients who face cancer-related decisions. Patients and Methods Two reviewers independently screened the 105 trials in the original 2017 Cochrane review to identify eligible trials of patient decision aids across the cancer continuum. Primary outcomes were attributes of the choice and decision-making process. Secondary outcomes were patient behavior and health system effects. A meta-analysis was conducted for similar outcome measures. Results Forty-six trials evaluated patient decision aids for cancer care, including 27 on screening decisions (59%), 12 on treatments (26%), four on genetic testing (9%), and three on prevention (6%). Common decisions were aboutprostate cancer screening (30%), colorectal cancer screening (22%), breast cancer treatment (13%), and prostate cancer treatment (9%). Compared with the control groups (usual care or alternative interventions), the patient decision aid group improved the match between the chosen option and the features that mattered most to the patient as demonstrated by improved knowledge (weighted mean difference, 12.88 of 100; 95% CI, 9.87 to 15.89; 24 trials), accurate risk perception (risk ratio [RR], 1.77; 95% CI, 1.22 to 2.56; six trials), and value-choice agreement (RR, 2.76; 95% CI, 1.57 to 4.84; nine trials). Compared with controls, the patient decision aid group improved the decision-making process with decreased decisional conflict (weighted mean difference, −9.56 of 100; 95% CI, −13.90 to −5.23; 12 trials), reduced clinician-controlled decision making (RR, 0.57; 95% CI, 0.41 to 0.79; eight trials), and fewer patients being indecisive (RR, 0.59; 95% CI, 0.45 to 0.78; nine trials). Conclusion Patient decision aids improve the attributes of the choice made and decision-making process for patients who face cancer-related decisions.

scholarly journals Measures of Decision Aid Quality Are Preference-Sensitive and Interest-Conflicted – 1: Normative Measures

2020 ◽  
Author(s):  
Jack Dowie ◽  
Mette Kjer Kaltoft ◽  
Vije Kumar Rajput
Keyword(s):  
Gold Standard ◽  
Decision Aid ◽  
Decision Aids ◽  
Quality Measures ◽  
Healthcare Research ◽  
Patient Decision Aid ◽  
High Quality ◽  
Patient Decision ◽  
Wide Definition ◽  
Definition Of

The belief that following rigorous inclusive methods will eliminate bias from ‘quality’ measures ignores the preferences necessarily embedded in any formative instrument. These preferences almost always reflect the interests of its developers when one uses the wide definition of ‘interest’ appropriate in healthcare research and provision. We focus on the International Patient Decision Aid Standards instrument, a popular normative measure of decision aid quality. Drawing on its application to a set of 23 breast cancer screening decision aids, we show the effects of modifications that reflect our own different interest-conflicted preferences. It is emphasised that the only objection is to the implication that any formative instrument should be promoted or treated as the ‘the gold standard’, without a conflict of interests disclaimer, and to the implication that other instruments cannot provide equally valid, high-quality measures.

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