Universidad Peruana Cayetano Heredia

Shared Decision Making in Pediatrics: A Systematic Review and Meta-analysis

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dc.contributor.author Wyatt, Kirk D.
dc.contributor.author List, Betsy
dc.contributor.author Brinkman, William B.
dc.contributor.author Prutsky Lopez, Gabriela
dc.contributor.author Asi, Noor
dc.contributor.author Erwin, Patricia
dc.contributor.author Wang, Zhen
dc.contributor.author Domecq Garces, Juan Pablo
dc.contributor.author Montori, Victor M.
dc.contributor.author LeBlanc, Annie
dc.date.accessioned 2019-02-06T14:59:04Z
dc.date.available 2019-02-06T14:59:04Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5507
dc.description.abstract BACKGROUND: Little is known about the impact of interventions to support shared decision making (SDM) with pediatric patients. OBJECTIVES: To summarize the efficacy of SDM interventions in pediatrics on patient-centered outcomes. DATA SOURCES: We searched Ovid Medline, Ovid Embase, Ovid Cochrane Library, Web of Science, Scopus, and Ovid PsycInfo from database inception to December 30, 2013, and performed an environmental scan. STUDY ELIGIBILITY CRITERIA: We included interventions designed to engage pediatric patients, parents, or both in a medical decision, regardless of study design or reported outcomes. STUDY APPRAISAL AND SYNTHESIS METHODS: We reviewed all studies in duplicate for inclusion, data extraction, and risk of bias assessment. Meta-analysis was performed on 3 outcomes: knowledge, decisional conflict, and satisfaction. RESULTS: Sixty-one citations describing 54 interventions met eligibility criteria. Fifteen studies reported outcomes such that they were eligible for inclusion in meta-analysis. Heterogeneity across studies was high. Meta-analysis revealed SDM interventions significantly improved knowledge (standardized mean difference [SMD] 1.21, 95% confidence interval [CI] 0.26 to 2.17, P = .01) and reduced decisional conflict (SMD -1.20, 95% CI -2.01 to -0.40, P = .003). Interventions showed a nonsignificant trend toward increased satisfaction (SMD 0.37, 95% CI -0.04 to 0.78, P = .08). LIMITATIONS: Included studies were heterogeneous in nature, including their conceptions of SDM. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: A limited evidence base suggests that pediatric SDM interventions improve knowledge and decisional conflict, but their impact on other outcomes is unclear. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Academic Pediatrics
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adolescent en_US
dc.subject Humans en_US
dc.subject Child en_US
dc.subject Child, Preschool en_US
dc.subject Infant en_US
dc.subject decision making en_US
dc.subject adolescent en_US
dc.subject child en_US
dc.subject Infant, Newborn en_US
dc.subject Decision Making en_US
dc.subject Decision Support Techniques en_US
dc.subject Patient Participation en_US
dc.subject Pediatrics en_US
dc.subject Physician-Patient Relations en_US
dc.subject Professional-Family Relations en_US
dc.subject child, preschool en_US
dc.subject decision aids en_US
dc.subject decision making, shared en_US
dc.subject decision support techniques en_US
dc.subject infant en_US
dc.subject infant, newborn en_US
dc.subject pediatrics en_US
dc.title Shared Decision Making in Pediatrics: A Systematic Review and Meta-analysis en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1016/j.acap.2015.03.011
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.relation.issn 1876-2867


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