title: A decision aid for considering indomethacin prophylaxis vs. symptomatic treatment of PDA for extreme low birth weight infants.
abstract: BACKGROUND
  Decision Aids (DA) are well established in various fields of medicine. It can improve the quality of decision-making and reduce decisional conflict. In neonatal care, and due to scientific equipoise, neonatologists caring for extreme low birth weight (ELBW) infants are in need to elicit parents' preferences with regard to the use of indomethacin therapy in ELBW infants. We aimed to develop a DA that elicits parents' preferences with regard to indomethacin therapy in ELBW infants.
  
  
  METHODS
  We developed a DA for the use of the indomethacin therapy in ELBW infants according to the Ottawa Decision Support Framework. The development process involved parents, neonatologists, DA developers and decision making experts. A pilot testing with healthy volunteers was conducted through an evaluation questionnaire, a knowledge scale, and a validated decisional conflict scale.
  
  
  RESULTS
  The DA is a computer-based interactive tool. In the first part, the DA provides information about patent ductus arteriosus (PDA) as a disease, the different treatment options, and the benefits and downsides of using indomethacin therapy in preterm infants. In the second part, it coaches the parent in the decision making process through clarifying values and preferences. Volunteers rated 10 out of 13 items of the DA positively and showed significant improvement on both the knowledge scale (p = 0.008) and the decisional conflict scale (p = 0.008).
  
  
  CONCLUSIONS
  We have developed a computer based DA to assess parental preferences with regard to indomethacin therapy in preterm infants. Future research will involve measurement of parental preferences to guide and augment the clinical decisions in current neonatal practice.
authors: Department of Pediatrics (Division of Neonatology), College of Medicine, King Saud University, Riyadh, Saudi Arabia. kfaleh@ksu.edu.sa
authors: Khalid M
authors: KM
authors: Alfaleh
authors: Eman
authors: E
authors: Al Luwaimi
authors: Turki M
authors: TM
authors: Alkharfi
authors: Saleh A
authors: SA
authors: Al-Alaiyan
mesh_terms: D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003661:Decision Support Techniques; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000517:prevention & control*; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D020300:Intracranial Hemorrhages / Q000517:prevention & control; D008171:Lung Diseases / Q000517:prevention & control; D010290:Parents; D010865:Pilot Projects; D012720:Severity of Illness Index
chemical_list: D002317:Cardiovascular Agents; D007213:Indomethacin