Shared decision making and decision aids in MEDLINE

Article type
Year
Authors
Ciapponi A1, Glujovsky D1, Bardach A1, Comande D1
1Argentine Cochrane Center IECS, Argentina
Abstract
Background: Shared decision-making (SDM) is an approach in which clinicians and patients communicate together using the best available evidence to make decisions. Decision aids (DA) are tools designed to facilitate SDM in healthcare decisions.

Objectives: To evaluate the frequency and categories of terms related to SDM and DA in MEDLINE from inception to date.

Methods: We used search strategies for SDM and for DA use (Fig 1) to assess temporal trends and patterns of categories by article type, gender, age group, subject, journal category and medical specialty.

Results: Both DA and particularly SDM began a steady growth in the new century (Fig 1). In Table 1 we described the proportion of reported categories for SDM (N = 6533) and DA records (N = 758). Not every study reported was classified within a category, i.e. only 53% of SDM studies and 63% of DA studies were linked to a medical specialty. The proportion of randomized controlled trials and systematic reviews are low, the gender distribution is balanced, the extreme age groups are less well represented, and surgery, family medicine and internal medicine are the most frequent medical specialties. A minority included the terms 'web-based/electronic formats'.

Conclusions: Although there has been a marked increase in MEDLINE records related to SDM and DA in the past 15 years, the absolute number still seems low, and the hard evidence evaluating them as interventions is even lower. Very few medical specialties seem to use or report on these topics. Notably, only a minority use web-based or electronic formats.