Hamburg University, School of Mathematics, Informatics and Natural Sciences, Hamburg, Germany.
Dtsch Arztebl Int. 2012 Jun;109(22-23):401-8. doi: 10.3238/arztebl.2012.0401. Epub 2012 Jun 4.
Patients want to be more involved in medical decision-making. To this end, some decision aids are now available.
We present an overview of this subject, in which we explain the terms "shared decision-making", "decision aid", and "evidence-based patient information" and survey information on the available decision aids in German and other languages on the basis of a literature search in MEDLINE, EMBASE and PsycInfo and a current Cochrane Review. We also searched the Internet for providers of decision aids in Germany.
Decision aids exist in the form of brochures, decision tables, videos, and computer programs; they address various topics in the prevention, diagnosis, and treatment of disease. They typically contain information on the advantages and disadvantages of the available options, as well as guidance for personal decision-making. They can be used alone or as a part of structured counseling or patient education. Minimal quality standards include an adequate evidence base, completeness, absence of bias, and intelligibility. Our search revealed 12 randomized controlled trials (RCTs) of decision aids in German and 106 RCTs of decision aids in other languages. These trials studied the outcome of the use of decision aids not just with respect to clinical developments, but also with respect to patient knowledge, adherence to treatment regimens, satisfaction, involvement in decision-making, autonomy preference, and decisional conflicts.
Only a small fraction of the available decision aids were systematically developed and have been subjected to systematic evaluation. Patients are still not receiving the help in decision-making to which medical ethics entitles them. Structures need to be put in place for the sustainable development, evaluation and implementation of high-quality decision aids.
患者希望更多地参与医疗决策。为此，现在有一些决策辅助工具可用。
我们介绍了这一主题的概述，解释了“共同决策”、“决策辅助”和“基于证据的患者信息”这三个术语，并根据 MEDLINE、EMBASE 和 PsycInfo 中的文献检索以及当前的 Cochrane 综述，调查了德语和其他语言的可用决策辅助工具的信息。我们还在德国互联网上搜索了决策辅助工具的提供者。
决策辅助工具以小册子、决策表、视频和计算机程序的形式存在；它们涉及疾病预防、诊断和治疗的各种主题。它们通常包含有关可用选项的优缺点的信息，以及个人决策的指导。它们可以单独使用，也可以作为结构化咨询或患者教育的一部分。最低质量标准包括充分的证据基础、完整性、无偏差和可理解性。我们的搜索结果显示，在德语中有 12 项关于决策辅助工具的随机对照试验（RCT），在其他语言中有 106 项 RCT。这些试验不仅研究了使用决策辅助工具对临床发展的影响，还研究了其对患者知识、治疗方案的遵守情况、满意度、参与决策、自主性偏好和决策冲突的影响。
只有一小部分可用的决策辅助工具是经过系统开发并经过系统评估的。患者仍然没有得到医学伦理所赋予的决策帮助。需要建立可持续发展、评估和实施高质量决策辅助工具的结构。
