title: Decision aids for localized prostate cancer treatment choice: Systematic review and meta-analysis.
abstract: Patients who are diagnosed with localized prostate cancer need to make critical treatment decisions that are sensitive to their values and preferences. The role of decision aids in facilitating these decisions is unknown. The authors conducted a systematic review of randomized trials of decision aids for localized prostate cancer. Teams of 2 reviewers independently identified, selected, and abstracted data from 14 eligible trials (n = 3377 men), of which 10 were conducted in North America. Of these, 11 trials compared decision aids with usual care, and 3 trials compared decision aids with other decision aids. Two trials suggested a modest positive impact on decisional regret. Results across studies varied widely for decisional conflict (4 studies), satisfaction with decision (2 studies), and knowledge (2 studies). No impact on treatment choices was observed (6 studies). In conclusion, scant evidence at high risk of bias suggests the variable impact of existing decision aids on a limited set of decisional processes and outcomes. Because current decision aids provide information but do not directly facilitate shared decision making, subsequent efforts would benefit from user-centered design of decision aids that promote shared decision making.
authors.affiliation: Endourology Fellow, Division of Urology, Department of Surgery, Western University, London, ON, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Woodstock General Hospital, Woodstock, ON, Canada.
authors.forename: Philippe D
authors.initials: PD
authors.lastname: Violette
authors.affiliation: Research Fellow, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada, Division of General Internal Medicine and Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Agoritsas
authors.affiliation: Doctoral Candidate, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Alexander
authors.affiliation: Consultant, Department of Urology, Tampere University Hospital, Tampere, Finland.
authors.forename: Jarno
authors.initials: J
authors.lastname: Riikonen
authors.affiliation: Consultant, Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Henrikki
authors.initials: H
authors.lastname: Santti
authors.affiliation: Medical Student, Faculty of Medicine, University of Toronto, Toronto, ON, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Arnav
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Medical Librarian, Health Sciences Library, McMaster University, Hamilton, ON, Canada.
authors.forename: Neera
authors.initials: N
authors.lastname: Bhatnagar
authors.affiliation: Professor, Department of Urology, University of Minnesota and Minneapolis Veterans Affairs Health Care System, Minneapolis, MN.
authors.forename: Philipp
authors.initials: P
authors.lastname: Dahm
authors.affiliation: Professor, Knowledge and Evaluation Research Unit, Division of Endocrinology and Diabetes, Departments of Medicine and Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Victor
authors.initials: V
authors.lastname: Montori
authors.affiliation: Distinguished Professor, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Guyatt
authors.affiliation: Adjunct Professor, Departments of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kari A O
authors.initials: KA
authors.lastname: Tikkinen
mesh_terms: D003661:Decision Support Techniques; D006801:Humans; D008297:Male; D015233:Models, Statistical; D010358:Patient Participation; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
keywords: decision making; decision support techniques; patient education as topic; patient participation; patient preference; patient satisfaction; prostatic neoplasms