Michigan State University, College of Human Medicine, Grand Rapids, MI, USA.
Department of Clinical Development, Odense University Hospital, Odense, Denmark.
Med Decis Making. 2021 Oct;41(7):780-800. doi: 10.1177/0272989X211021397. Epub 2021 Jul 1.
The objective of this International Patient Decision Aids Standard (IPDAS) review is to update and synthesize theoretical and empirical evidence on how balanced information can be presented and measured in patient decision aids (PtDAs).
A multidisciplinary team conducted a scoping review using 2 search strategies in multiple electronic databases evaluating the ways investigators defined and measured the balance of information provided about options in PtDAs. The first strategy combined a search informed by the Cochrane Review of the Effectiveness of Decision Aids with a search on balanced information. The second strategy repeated the search published in the 2013 IPDAS update on balanced presentation.
Of 2450 unique citations reviewed, the full text of 168 articles was screened for eligibility. Sixty-four articles were included in the review, of which 13 provided definitions of balanced presentation, 8 evaluated mechanisms that may introduce bias, and 42 quantitatively measured balanced with methods consistent with the IPDAS criteria in PtDAs. The revised definition of balanced information is, "Objective, complete, salient, transparent, evidence-informed, and unbiased presentation of text and visual information about the condition and all relevant options (with important elements including the features, benefits, harms and procedures of those options) in a way that does not favor one option over another and enables individuals to focus attention on important elements and process this information."
Developers can increase the balance of information in PtDAs by informing their structure and design elements using the IPDAS checklist. We suggest that new PtDA components pertaining to balance be evaluated for cognitive bias with experimental methods as well by objectively evaluating patients' and content experts' beliefs from multiple perspectives.
本国际患者决策辅助工具标准（IPDAS）评价旨在更新和综合关于如何在患者决策辅助工具（PtDAs）中呈现和测量平衡信息的理论和经验证据。
一个多学科团队使用两种搜索策略在多个电子数据库中进行了范围审查，评估了研究人员定义和测量 PtDAs 中提供的选项的平衡信息的方式。第一个策略结合了 Cochrane 对决策辅助工具有效性的评价和平衡信息搜索的信息。第二个策略重复了 2013 年 IPDAS 更新中关于平衡呈现的搜索。
在审查的 2450 条独特引用中，全文筛选了 168 篇文章以确定其是否符合条件。有 64 篇文章被纳入审查，其中 13 篇提供了平衡呈现的定义，8 篇评估了可能引入偏差的机制，42 篇定量测量了平衡，方法与 PtDAs 中的 IPDAS 标准一致。平衡信息的修订定义是，“以客观、完整、突出、透明、基于证据和无偏见的方式呈现关于疾病和所有相关选项的文本和视觉信息（重要元素包括这些选项的特征、益处、危害和程序），不偏向任何一个选项，使个人能够关注重要元素并处理这些信息。”
开发人员可以通过使用 IPDAS 清单告知其结构和设计元素，从而在 PtDAs 中增加信息的平衡。我们建议，与认知偏差有关的新的 PtDA 组件应通过实验方法以及从多个角度客观评估患者和内容专家的信念来进行评估。
