Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Fitzroy, Melbourne, Australia.
Ann Vasc Surg. 2024 Sep;106:25-36. doi: 10.1016/j.avsg.2024.02.014. Epub 2024 Apr 8.
In recent years, decision support tools (DSTs) in various fields of medicine have emerged to aid clinicians and patients in the process of shared decision-making (SDM). This scoping review aims to identify the existing DSTs for selecting treatments in lower extremity arterial disease and to evaluate their effectiveness in facilitating SDM.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews were followed. A literature search was conducted across MEDLINE, EMBASE, and Cochrane databases, along with the Decision Aid Library Inventory, for studies published between January 2000 and June 2023. Articles reporting the development and/or clinical application of a DST specific to lower extremity arterial disease were included. A narrative synthesis of the results was performed and findings were presented in tabular formats.
Five studies and 5 unique DSTs were included. Presenting formats included websites, booklets, brochures, and pocket cards. Overall, a high degree of heterogeneity was observed across all DSTs in their format, content, and delivery. A widespread acceptability and satisfaction were reported among patients and clinicians. However, their effect at improving SDM remains uncertain due to the lack of standardized outcome metrics.
The development and implementation of DSTs for lower limb arterial disease treatment discussion remain in the early stages. This review lays the foundation for future studies to continue exploring optimal strategies for DST development and their role in supporting SDM.
近年来，各种医学领域的决策支持工具（DST）已经出现，以帮助临床医生和患者在共同决策（SDM）过程中做出决策。本范围综述旨在确定用于选择下肢动脉疾病治疗方法的现有 DST，并评估它们在促进 SDM 方面的有效性。
本研究遵循了系统评价和荟萃分析的首选报告项目（PRISMA）范围综述指南。对 MEDLINE、EMBASE 和 Cochrane 数据库以及决策辅助库目录进行了文献检索，检索时间范围为 2000 年 1 月至 2023 年 6 月。纳入了专门针对下肢动脉疾病的 DST 开发和/或临床应用的研究。对结果进行了叙述性综合，并以表格形式呈现了发现。
纳入了 5 项研究和 5 个独特的 DST。展示格式包括网站、小册子、传单和袖珍卡。总体而言，所有 DST 在格式、内容和交付方面都存在高度的异质性。患者和临床医生报告了广泛的可接受性和满意度。然而，由于缺乏标准化的结果衡量指标，他们在改善 SDM 方面的效果仍不确定。
下肢动脉疾病治疗讨论的 DST 的开发和实施仍处于早期阶段。本综述为未来的研究奠定了基础，以继续探索 DST 开发的最佳策略及其在支持 SDM 中的作用。
