Effectiveness of patient decision aids for cardiovascular decisions: systematic review with sex/gender-based analysis.
Krystina B Lewis, Ian D Graham, Sandra B Lauck and 4 others
PMID 40440359WHAT IT FOUND
The main measure of whether choices matched patients' values did not improve with cardiovascular decision aids.
They did improve knowledge, risk perception, feeling informed, clarity about values, and patient-clinician communication.
Key findings
01A primary measure of whether choices matched patients' values showed no difference between groups.
02Decision aids improved knowledge by 11.51 points on a 100-point scale compared with usual care.
03For surgical treatment choices, decision aids made patients more likely to choose a conservative option (RR 0.81; 95% CI 0.71 to 0.94; 10 trials).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Ten of 32 trials had a high risk of bias. Only five trials measured values-choice congruence, and only two were pooled for it. The trials covered very different cardiovascular decisions and settings, so pooled estimates should be read as a range rather than a result for any one decision. Most trials did not report sex or gender outcomes separately by study arm, so the review cannot show whether decision aids work equally well for all sex or gender groups. Samples were often mostly male and white, and some trials had very few women, so findings may not apply to all patients. Twelve trials were published 10 or more years ago.
Declared interests
Funding was from the Canadian Institutes of Health Research.
The easy way to misread this
Do not conclude that decision aids improve cardiovascular clinical outcomes or work equally well across sex and gender groups. The review measured decision process outcomes, and most trials did not report outcomes separately by sex or gender by study arm.