BMC Med Inform Decis Mak - Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards.

Tópicos

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Resumo

CKGROUND: Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards.METHODS: We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions. In conducting this work, we noted emerging and research issues that require attention and may inform this quality dimension in the future.RESULTS: This dimension requires patient decision aids to be based on research evidence about the relevant options and the nature and likelihood of their effect on outcomes that matter to patients. The synthesis of evidence should be comprehensive and up-to-date, and the evidence itself subject to critical appraisal. Ethical (informed patient choice), quality-of-care (patient-centered care), and scientific (evidence-based medicine) arguments justify this requirement. Empirical evidence suggests that over two thirds of available decision aids are based on high-quality evidence syntheses. Emerging issues identified include the duties of developers regarding the conduct of systematic reviews, the impact of comparative effectiveness research, their link with guidelines based on the same evidence, and how to present the developers' confidence in the estimates to the end-users. Systematic application of the GRADE system, common in contemporary practice guideline development, could enhance satisfaction of this dimension.CONCLUSIONS: While theoretical and practical issues remained to be addressed, high-quality patient decision aids should adhere to this dimension requiring they be based on comprehensive and up-to-date summaries of critically appraised evidence.

Resumo Limpo

ckground patient clinician expect patient decis aid base best avail research evid sinc expect translat qualiti dimens intern patient decis aid standardsmethod review standard avail literatur evid base decis aid well search parallel activ evid brought bear inform clinic decis conduct work note emerg research issu requir attent may inform qualiti dimens futureresult dimens requir patient decis aid base research evid relev option natur likelihood effect outcom matter patient synthesi evid comprehens uptod evid subject critic apprais ethic inform patient choic qualityofcar patientcent care scientif evidencebas medicin argument justifi requir empir evid suggest two third avail decis aid base highqual evid synthes emerg issu identifi includ duti develop regard conduct systemat review impact compar effect research link guidelin base evid present develop confid estim endus systemat applic grade system common contemporari practic guidelin develop enhanc satisfact dimensionconclus theoret practic issu remain address highqual patient decis aid adher dimens requir base comprehens uptod summari critic apprais evid

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