BMC Med Inform Decis Mak - A systematic development process for patient decision aids.

Tópicos

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Resumo

CKGROUND: The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it.METHODS: Our review drew on three sources: a) published papers describing PtDAs evaluated in randomised controlled trials and included in the most recent Cochrane Collaboration review; b) linked papers cited in the trial reports that described how the PtDAs had been developed; and c) papers and web reports outlining the development process used by organisations experienced in developing multiple PtDAs. We then developed an extended model of the development process indicating the various steps on which documentation is required, as well as a checklist to assess the frequency with which each of the elements was publicly reported.RESULTS: Key features common to all patient decision aid (PtDA) development processes include: scoping and design; development of a prototype; 'alpha' testing with patients and clinicians in an iterative process; 'beta' testing in 'real life' conditions (field tests); and production of a final version for use and/or further evaluation. Only about half of the published reports on the development of PtDAs that we reviewed appear to have been field tested with patients, and even fewer had been reviewed or tested by clinicians not involved in the development process. Very few described a distribution strategy, and surprisingly few (17%) described a method for reviewing and synthesizing the clinical evidence. We describe a model development process that includes all the original elements of the original IPDAS criterion, expanded to include consideration of format and distribution plans as well as prototype development.CONCLUSIONS: The case for including each of the elements outlined in our model development process is pragmatic rather than evidence-based. Optimal methods for ensuring that each stage of the process is carried out effectively require further development and testing.

Resumo Limpo

ckground origin version intern patient decis aid standard ipda recommend patient decis aid ptdas care develop usertest open scrutini welldocu systemat appli develop process carri review check relev scope qualiti dimens necessari updat itmethod review drew three sourc publish paper describ ptdas evalu randomis control trial includ recent cochran collabor review b link paper cite trial report describ ptdas develop c paper web report outlin develop process use organis experienc develop multipl ptdas develop extend model develop process indic various step document requir well checklist assess frequenc element public reportedresult key featur common patient decis aid ptda develop process includ scope design develop prototyp alpha test patient clinician iter process beta test real life condit field test product final version use andor evalu half publish report develop ptdas review appear field test patient even fewer review test clinician involv develop process describ distribut strategi surpris describ method review synthes clinic evid describ model develop process includ origin element origin ipda criterion expand includ consider format distribut plan well prototyp developmentconclus case includ element outlin model develop process pragmat rather evidencebas optim method ensur stage process carri effect requir develop test

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