title: Use of decision aids for shared decision making in venous thromboembolism: A systematic review.
abstract: BACKGROUND
  Optimal care of patients with venous thromboembolism requires the input of patient preferences into clinical decision-making. However, the availability and impact of decision aids to facilitate shared decision making in care of venous thromboembolism is not well known.
  
  
  OBJECTIVE
  To assess the availability, clinical impact and outcomes associated with the use of decision aids in patients with or at risk for venous thromboembolism.
  
  
  METHODS
  A systematic review of the literature was performed exploring the use of decision aids in patients with venous thromboembolism. Criteria for primary inclusion required use of patient values clarification in the decision aid. A secondary review without the requirement of a patient values clarification was performed to be more inclusive. The data was summarized such that knowledge gaps and opportunities for enquiry were identified.
  
  
  RESULTS
  The primary review identified one study that explored the decision to extend anticoagulation in patients with a recent venous thromboembolism beyond the stipulated 3-month duration. The secondary review identified an additional study exploring the decision to undergo computer tomography testing in patients at low risk for pulmonary embolism in an emergency department setting. Both studies were of modest quality given a lack of control group for comparison analysis.
  
  
  CONCLUSIONS
  Despite numerous calls to increase use of shared decision-making, a paucity of data exists to help patients engage in the treatment decisions for venous thromboembolism. Future studies of additional VTE clinical decisions with longer-term clinical outcomes appear necessary.
authors.affiliation: Frankel Cardiovascular Center, University of Michigan Medical Center, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan Medical Center, Ann Arbor, MI, USA. Electronic address: gbarnes@umich.edu.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Barnes
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Izzo
authors.affiliation: Taubman Health Science Library, University of Michigan Medical Center, Ann Arbor, MI, USA.
authors.forename: Marisa L
authors.initials: ML
authors.lastname: Conte
authors.affiliation: Institute for Healthcare Policy and Innovation, University of Michigan Medical Center, Ann Arbor, MI, USA; Department of Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
authors.affiliation: Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Holbrook
authors.affiliation: Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA; VA Salt Lake City, Salt Lake City, UT, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D000066491:Clinical Decision-Making / Q000379:methods*; D003657:Decision Making; D003661:Decision Support Techniques; D006801:Humans; D010358:Patient Participation; D054556:Venous Thromboembolism / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants
keywords: Decision making; Decision support techniques; Patient preferences; Venous thromboembolism