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24 papers found.
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Development of a decision aid for cardiopulmonary resuscitation and invasive mechanical ventilation in the intensive care unit employing user-centered design and a wiki platform for rapid prototyping

prototyping Ariane Plaisance 0 1 Holly O. Witteman Annie LeBlanc 0 Jennifer Kryworuchko Daren Keith Heyland Mark H. Ebell Louisa Blair 0 Diane Tapp Audrey Dupuis Carole-Anne Lavoie-B eÂrard Carrie Anna McGinn ... Resources: Jennifer Kryworuchko, Daren Keith Heyland, Mark H. Ebell. Supervision: Annie LeBlanc, France LeÂgareÂ, Patrick Michel Archambault. Validation: Jennifer Kryworuchko. Writing ± original draft

Effective strategies for scaling up evidence-based practices in primary care: a systematic review

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non...

Effective strategies for scaling up evidence-based practices in primary care: a systematic review

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non...

Effective strategies for scaling up evidence-based practices in primary care: a systematic review

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non...

Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II

Purpose Osteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient’s estimated risk of fracture using the FRAX calculator is unknown. Methods Patient-level, randomized, three-arm trial enrolling women over 50 with...

Implementation of a new prenatal care model to reduce office visits and increase connectivity and continuity of care: protocol for a mixed-methods study

Background Most low-risk pregnant women receive the standard model of prenatal care with frequent office visits. Research suggests that a reduced schedule of visits among low-risk women could be implemented without increasing adverse maternal or fetal outcomes, but patient satisfaction with these models varies. We aim to determine the effectiveness and feasibility of a new...

Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis

Background Gender differences in communication styles between clinicians and patients have been postulated to impact patient care, but the extent to which the gender dyad structure impacts outcomes in shared decision making remains unclear. Methods Participant-level meta-analysis of 775 clinical encounters within 7 randomized trials where decision aids, shared decision making...

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

Background 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...

Women’s values in contraceptive choice: a systematic review of relevant attributes included in decision aids

Background Women can choose from a range of contraceptive methods that differ in important ways. Inadequate decision support may lead them to select a method that poorly fits their circumstances, leading to dissatisfaction, misuse, or nonuse. Decision support interventions, such as decision aids, may help women choose a method of contraception that best fits their personal...

Study protocol: a systematic review of pediatric shared decision making

Background Shared decision making in pediatrics is unique because it often involves active participation of both the child or adolescent patient and his or her caregiver(s) in the decision making process with the clinician or care team, and the extent to which the patient is involved is commensurate with their developmental level. However, little is known about the nature of...

Peering into the black box: a meta-analysis of how clinicians use decision aids during clinical encounters

Objective To quantify the extent to which clinicians use clinically-efficacious decision aids as intended during implementation in practice and how fidelity to usage instructions correlates with shared decision making (SDM) outcomes. Methods Participant-level meta-analysis including six practice-based randomized controlled trials of SDM in various clinical settings encompassing a...

Shared Decision Making in Patients with Stable Coronary Artery Disease: PCI Choice

Background Percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) are comparable, alternative therapies for many patients with stable angina; however, patients may have misconceptions regarding the impact of PCI on risk of death and myocardial infarction (MI) in stable coronary artery disease (CAD). Methods and Results We designed and developed a patient...

Shared decision making for patients with type 2 diabetes: a randomized trial in primary care

Background Patient-centered diabetes care requires shared decision making (SDM). Decision aids promote SDM, but their efficacy in nonacademic and rural primary care clinics is unclear. Methods We cluster-randomized 10 practices in a concealed fashion to implement either a decision aid (DA) about starting statins or one about choosing antihyperglycemic agents. Each practice served...

Lessons learned from the conduct of a multisite cluster randomized practical trial of decision aids in rural and suburban primary care practices

Background The decision aids for diabetes (DAD) trial explored the feasibility of testing the effectiveness of decision aids (DAs) about coronary prevention and diabetes medications in community-based primary care practices, including rural clinics that care for patients with type 2 diabetes. Methods As originally designed, we invited clinicians in eight practices to participate...

Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

Background The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. Methods For every...

Effectiveness of the head CT choice decision aid in parents of children with minor head trauma: study protocol for a multicenter randomized trial

B Kharbanda 11 Jeffrey P Louie 10 Peter S Dayan 15 Leah Tzimenatos 14 Sandra L Wootton-Gorges 9 James L Homme 6 Laurie Pencille RN 1 Annie LeBlanc 1 8 13 Jessica J Westphal 7 Kathy Shepel 4 Nilay D

Translating comparative effectiveness of depression medications into practice by comparing the depression medication choice decision aid to usual care: study protocol for a randomized controlled trial

Background Comparative effectiveness research (CER) documents important differences in antidepressants in terms of efficacy, safety, cost, and burden to the patient. Decision aids can adapt this evidence to help patients participate in making informed choices. In turn, antidepressant therapy will more likely reflect patients’ values and context, leading to improved adherence and...

Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care: the DECISION+ pilot trial

Background The misuse and limited effectiveness of antibiotics for acute respiratory infections (ARIs) are well documented, and current approaches targeting physicians or patients to improve appropriate use have had limited effect. Shared decision-making could be a promising strategy to improve appropriate antibiotic use for ARIs, but very little is known about its implementation...

Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial

Background Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced cardiac testing. Shared decision-making, including educating patients regarding their 45-day risk for acute coronary syndrome (ACS) and management options, might safely decrease...

A systematic review of shared decision making interventions in chronic conditions: a review protocol

Background Chronic conditions are a major source of morbidity, mortality and cost worldwide. Shared decision making is one way to improve care for patients with chronic conditions. Although it has been widely studied, the effect of shared decision making in the context of chronic conditions is unknown. Methods/Design We will perform a systematic review with the objective of...