Ania Syrowatka|Dörthe Krömker|Ari N. Meguerditchian|Robyn Tamblyn
Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses
McGill University|McGill University|McGill University|McGill University Health Centre|McGill University
background patient information education decision aids gradually moving toward online computerbased environments considerable research conducted guide content presentation decision aids however given relatively new shift computerbased support little attention given multimedia interactivity improve upon paperbased decision aids objective first objective review summarize published literature proposed classification features integrated computerbased decision aids building classification second objective assess whether integration specific features associated higherquality decision making methods relevant studies located searching medline embase cinahl central databases review identified studies evaluated computerbased decision aids adults faced preferencesensitive medical decisions reported quality decisionmaking outcomes thematic synthesis conducted develop classification features subsequently metaanalyses conducted based standardized mean differences smd randomized controlled trials rcts reported knowledge decisional conflict subgroup analyses compared pooled smds decision aids incorporated specific feature computerbased decision aids incorporate feature assess whether specific features improved quality decision making results 3541 unique publications 58 studies met target criteria included thematic synthesis synthesis identified six features content control tailoring patient narratives explicit values clarification feedback social support subset 26 rcts thematic synthesis used conduct metaanalyses expected computerbased decision aids performed better usual care alternative aids however features performed better others integration content control improved quality decision making smd 059 vs 023 knowledge smd 039 vs 029 decisional conflict contrast tailoring reduced quality decision making smd 040 vs 071 knowledge smd 025 vs 052 decisional conflict similarly patient narratives also reduced quality decision making smd 043 vs 065 knowledge smd 017 vs 046 decisional conflict results varied different types explicit values clarification feedback social support conclusions integration media rich interactive features computerbased decision aids improve quality preferencesensitive decision making however emerging field limited evidence guide use systematic review thematic synthesis identified features integrated available computerbased decision aids effort facilitate reporting features promote integration features decision aids metaanalyses associated subgroup analyses provide preliminary evidence support integration specific features future decision aids research focus clarifying independent contributions specific features experimental designs refining designs features improve effectiveness