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Review: health care decision aids improve knowledge, decrease decisional conflict, and increase active participation

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 QUESTION: Do decision aids (interventions providing information on options and outcomes designed to help people make specific and deliberate choices related to their health) used as adjuncts to counselling from health care practitioners improve decision making and outcomes for people who are making treatment or screening decisions?

Data sources

Studies were identified by searching Medline (1966 to April 1998), EMBASE/Excerpta Medica (1980 to November 1998), PsycINFO (1979 to March 1998), CINAHL (1983 to February 1998), Aidsline (1980 to 1998), CancerLit (1983 to April 1998), Cochrane Library (1998, issue 4), personal files, and 3 health care journals.

Study selection

Randomised controlled trials were selected if decision aids were compared with controls or alternative interventions and participants were >14 years of age and were making health care choices among options for treatment and screening issues. Studies were excluded if they used hypothetical situations or pertained to choices about lifestyle, participation in a clinical trial, advance directives, general education, or patient compliance.

Data extraction

Data were extracted on patient numbers, choices considered, …

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  • Source of funding: Medical Research Council of Canada.

  • For correspondence: Dr AM O'Connor, University of Ottawa School of Nursing and Faculty of Medicine, Loeb Health Research Institute Clinical Epidemiology Unit, Ottawa Hospital, Civic Campus, Ottawa, Ontario K1Y 4E9, Canada. Fax +1 613 761 5492.

  • A modified version of the abstract and commentary also appears in Evidence-Based Nursing