Kennedy Andrew D M
Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UK.
Health Expect. 2003 Sep;6(3):255-68. doi: 10.1046/j.1369-6513.2003.00240.x.
Attempts to synthesize the evidence on the effects of decision aids have been hampered by the lack of consensus regarding how such effectiveness should be measured. This paper seeks to describe and critically assess the range of measures of effectiveness used in randomized controlled trials of decision aids.
The published systematic reviews of the field were used to identify primary studies evaluating the effects of decision aids.
Non-randomized trials were excluded from this review. As were abstracts and theses of subsequently published studies, methodological papers and reports of subgroups of a study's main publication.
A wide range of measures were used to evaluate the effectiveness of decision aids. The most commonly used measures sought to assess treatment decisions, patient's knowledge and the decision-making process. This pattern was repeated when primary measures of effectiveness were examined. No study attempted to measure the extent to which decisions made were consistent with patient's values.
Within the current literature there is little consensus on what the aims of decision aids should be. If we can agree that the aim of a decision aid is to help patients make specific personal treatment choices, then evaluations of decision aids should measure the primary effectiveness of their interventions in terms of the extent to which they enable patient's to undergo treatments that agree with their values.
关于决策辅助工具效果的证据综合工作因在如何衡量此类效果方面缺乏共识而受阻。本文旨在描述并批判性地评估决策辅助工具随机对照试验中使用的一系列效果衡量指标。
利用该领域已发表的系统评价来识别评估决策辅助工具效果的原始研究。
本综述排除非随机试验。后续发表研究的摘要和论文、方法学论文以及研究主要出版物子组的报告也被排除。
广泛使用了一系列指标来评估决策辅助工具的效果。最常用的指标旨在评估治疗决策、患者知识和决策过程。在检查效果的主要指标时，这种模式再次出现。没有研究试图衡量所做决策与患者价值观的一致程度。
在当前文献中，对于决策辅助工具的目标应该是什么几乎没有共识。如果我们能够认同决策辅助工具的目标是帮助患者做出特定的个人治疗选择，那么对决策辅助工具的评估就应该衡量其干预措施在使患者接受符合其价值观的治疗方面的主要效果。
