title: Development of a patient decision aid prototype for adults with obstructive sleep apnea.
abstract: OBJECTIVE
  To describe the development and assess the usability of a patient decision aid (PtDA) prototype designed for newly diagnosed, treatment-naïve, obstructive sleep apnea (OSA) patients.
  
  
  METHODS
  A web-based PtDA was developed which focuses on two first-line treatment options: continuous positive airway pressure (CPAP) and mandibular advancement splints (MAS). Development was guided by the International Patient Decision Aid Standards (IPDAS). Usability was assessed in individuals at high risk for OSA based on the STOP-Bang questionnaire, the patient acceptance of decision aid, the System Usability Scale (SUS), and content analysis of open-ended user feedback.
  
  
  RESULTS
  Eighty eligible participants completed the survey. The mean age was 54 years (SD = 8.9), 60 % of the sample was male, 78 % were university-educated, and 64 % were employed full-time. Participants took an average of 13.7 min (SD = 9.6) to complete the PtDA, with 39 participants choosing CPAP, 25 choosing MAS, and 16 choosing no treatment. The mean SUS score was 78.22 (SD = 15.13). The majority of individuals thought the PtDA was useful in making a decision (n = 77, 96 %) and would recommend it to others (n = 77, 96 %), while a third (n = 26, 33 %) thought it was slanted towards CPAP.
  
  
  CONCLUSIONS
  The SUS indicated that the PtDA was acceptable and useful for participants. And useful for participants. User feedback has been used to improve the prototype, which will now undergo further testing in patients at the Vancouver Sleep Disorders Clinic.
authors.affiliation: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. logantrenaman@gmail.com.|Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. logantrenaman@gmail.com.|Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. logantrenaman@gmail.com.
authors.forename: Logan
authors.initials: L
authors.lastname: Trenaman
authors.affiliation: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Munro
authors.affiliation: Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Almeida
authors.affiliation: Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Najib
authors.initials: N
authors.lastname: Ayas
authors.affiliation: Department of Computer Science, University of British Columbia, Vancouver, BC, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Hicklin
authors.affiliation: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.|Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Bansback
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure; D003661:Decision Support Techniques; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D019186:Mandibular Advancement; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*
keywords: Continuous positive airway pressure; Mandibular advancement splints; Obstructive sleep apnea; Patient decision aid