title: Effectiveness of a web-based, individually tailored decision aid for depression or acute low back pain: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of a web-based, individually tailored decision aid (Patient Dialogue) on depression or acute low back pain for insurees of a German sickness fund.
  
  
  METHODS
  Patient Dialogue (PD) was compared to the non-tailored Static Patient Information (SPI) in an online randomized controlled trial (RCT). The primary outcome was decisional conflict; secondary outcomes included knowledge, preparation for decision-making, preference for participation, involvement in decision-making, decision regret, and adherence.
  
  
  RESULTS
  Out of 2480 randomized participants, 657 (26.5%) provided analyzable data immediately after using the system. Three months later, data from 131 (5.3%) participants could be included in the analysis. The PD group reported a significantly lower overall decisional conflict than the SPI group (38.7 vs. 45.1; p=0.028 via multiple imputation estimator). The largest standardized effect (Cohen's d 0.56) resulted from the preparation for decision-making (PD 59.4 vs. SPI 46.8; p<0.001).
  
  
  CONCLUSIONS
  PD may be an effective tool to reduce decisional conflict and prepare participants for treatment decision-making. However, the large dropout rate needs to be taken into account.
  
  
  CONCLUSIONS
  This study shows how a health insurance fund can support shared decision-making and how a decision aid can be evaluated in a RCT under routine care conditions.
authors.affiliation: University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Simon
authors.forename: Levente
authors.initials: L
authors.lastname: Kriston
authors.forename: Alessa
authors.initials: A
authors.lastname: von Wolff
authors.forename: Angela
authors.initials: A
authors.lastname: Buchholz
authors.forename: Christine
authors.initials: C
authors.lastname: Vietor
authors.forename: Torsten
authors.initials: T
authors.lastname: Hecke
authors.forename: Andreas
authors.initials: A
authors.lastname: Loh
authors.forename: Matthias
authors.initials: M
authors.lastname: Zenker
authors.forename: Mario
authors.initials: M
authors.lastname: Weiss
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003220:Conflict, Psychological; D003657:Decision Making; D003661:Decision Support Techniques; D003863:Depression / Q000523:psychology* / Q000628:therapy; D005260:Female; D005858:Germany; D006801:Humans; D007348:Insurance, Health; D020407:Internet; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods; D057240:Patient Preference; D018802:Patient-Centered Care; D012044:Regression Analysis