Witteman Holly O, Gavaruzzi Teresa, Scherer Laura D, Pieterse Arwen H, Fuhrel-Forbis Andrea, Chipenda Dansokho Selma, Exe Nicole, Kahn Valerie C, Feldman-Stewart Deb, Col Nananda F, Turgeon Alexis F, Fagerlin Angela
Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada (HOW)
Office of Education and Continuing Professional Development, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada (HOW, SCD)
Med Decis Making. 2016 Aug;36(6):760-76. doi: 10.1177/0272989X16634085. Epub 2016 Apr 4.
Diverse values clarification methods exist. It is important to understand which, if any, of their design features help people clarify values relevant to a health decision.
To explore the effects of design features of explicit values clarification methods on outcomes including decisional conflict, values congruence, and decisional regret.
MEDLINE, all EBM Reviews, CINAHL, EMBASE, Google Scholar, manual search of reference lists, and expert contacts.
Articles were included if they described the evaluation of 1 or more explicit values clarification methods.
We extracted details about the evaluation, whether it was conducted in the context of actual or hypothetical decisions, and the results of the evaluation. We combined these data with data from a previous review about each values clarification method's design features.
We identified 20 evaluations of values clarification methods within 19 articles. Reported outcomes were heterogeneous. Few studies reported values congruence or postdecision outcomes. The most promising design feature identified was explicitly showing people the implications of their values, for example, by displaying the extent to which each of their decision options aligns with what matters to them.
Because of the heterogeneity of outcomes, we were unable to perform a meta-analysis. Results should be interpreted with caution.
Few values clarification methods have been evaluated experimentally. More research is needed to determine effects of different design features of values clarification methods and to establish best practices in values clarification. When feasible, evaluations should assess values congruence and postdecision measures of longer-term outcomes.
存在多种价值观澄清方法。了解其设计特征中哪些（如果有的话）有助于人们澄清与健康决策相关的价值观很重要。
探讨明确的价值观澄清方法的设计特征对包括决策冲突、价值观一致性和决策后悔等结果的影响。
医学文献数据库（MEDLINE）、所有循证医学综述、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）、谷歌学术、参考文献列表的手工检索以及专家联系。
如果文章描述了对一种或多种明确的价值观澄清方法的评估，则将其纳入。
我们提取了评估的详细信息，评估是在实际决策还是假设决策的背景下进行的，以及评估结果。我们将这些数据与之前关于每种价值观澄清方法设计特征的综述数据相结合。
我们在19篇文章中确定了20项价值观澄清方法的评估。报告的结果各不相同。很少有研究报告价值观一致性或决策后结果。确定的最有前景的设计特征是向人们明确展示其价值观的影响，例如，通过展示每个决策选项与其重要事项的契合程度。
由于结果的异质性，我们无法进行荟萃分析。结果应谨慎解释。
很少有价值观澄清方法经过实验评估。需要更多研究来确定价值观澄清方法不同设计特征的影响，并确立价值观澄清的最佳实践。在可行的情况下，评估应评估价值观一致性和长期结果的决策后指标。
