Providing balanced information about options in patient decision aids: an update from the International Patient Decision Aid Standards

Richard W. Martin, Stina Brogård Andersen, Mary Ann O’Brien, Paulina Bravo, Tammy Hoffmann, Karina Olling, Heather L. Shepherd, Kathrina Dankl, Dawn Stacey, Karina Dahl Steffensen

Publications: Contribution to journalJournal articleResearchpeer-review

Abstract

Background

The objective of this International Patient Decision Aids Standard (IPDAS) review is to update and synthesize theoretical and empirical evidence on how balanced information can be presented and measured in patient decision aids (PtDAs).
Methods

A multidisciplinary team conducted a scoping review using 2 search strategies in multiple electronic databases evaluating the ways investigators defined and measured the balance of information provided about options in PtDAs. The first strategy combined a search informed by the Cochrane Review of the Effectiveness of Decision Aids with a search on balanced information. The second strategy repeated the search published in the 2013 IPDAS update on balanced presentation.
Results

Of 2450 unique citations reviewed, the full text of 168 articles was screened for eligibility. Sixty-four articles were included in the review, of which 13 provided definitions of balanced presentation, 8 evaluated mechanisms that may introduce bias, and 42 quantitatively measured balanced with methods consistent with the IPDAS criteria in PtDAs. The revised definition of balanced information is, “Objective, complete, salient, transparent, evidence-informed, and unbiased presentation of text and visual information about the condition and all relevant options (with important elements including the features, benefits, harms and procedures of those options) in a way that does not favor one option over another and enables individuals to focus attention on important elements and process this information.”
Conclusions

Developers can increase the balance of information in PtDAs by informing their structure and design elements using the IPDAS checklist. We suggest that new PtDA components pertaining to balance be evaluated for cognitive bias with experimental methods as well by objectively evaluating patients’ and content experts’ beliefs from multiple perspectives.
Original languageEnglish
JournalMedical Decision Making
Volume41
Issue number7
Pages (from-to)780-800
Number of pages20
ISSN0272-989X
DOIs
Publication statusE-pub ahead of print - 1 Jul 2021

Keywords

  • patient decision aids
  • risk communication
  • balance
  • framing
  • bias
  • choice bracketing
  • shared decision making
  • user-centered design

Artistic research

  • No

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