Page 453 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer

Appendix Table C3.3. Lin 2009, 197 systematic review of patient decision aids

Author Year [PMID] Lin 2009 197 [19841280]
Design A systematic review of patient decision aids for prostate cancer treatment
Population Men with low-risk prostate cancer who had the option of RP, RT, or WW
Intervention (Exposure) Various decision aids (written information package, consultation with nurse or urologist, generic video, interactive
computer program/CD-ROM decision aid, personalized multidisciplinary consultation, either stand-alone or in
combinations)
Results MEDLINE, CINAHL, Web of Science, and Cochrane Library initial search yielded 219 articles. 13 (3 RCTs (1 poor and
2 good per Jadad rating) and 10 nonrandomized trials) met eligibility criteria (inception through 3/2009).
Key findings
1. Majority of DAs were developed de novo
2. The participants in general found the DAs to be informative.
3. One RCT reported a decrease in anxiety in participants in the intervention arm (written information package with
discussion, a list of questions they could ask their physician, and an audiotape of the medical consultation) versus
written information alone. 205
4. One RCT found that there was no difference in satisfaction with treatment choice between those who received
individualized DAs and those using a generic DA. 204
5. One RCT found that the men in the DA arm selected their physician’s treatment choice less often than those who
received usual care. 203
6. The nonrandomized studies reported that DAs appeared to increase patients’ knowledge concerning prostate cancer
and its treatments.

Comments As noted by the systematic review authors: few high quality trials, heterogeneous outcome measures, and the quality of
the information provided in the DAs themselves were not assessed and therefore whether these DAs met the quality
standards set by the International Patient Decision Aids Standards Collaboration could not be determined. 206
AMSTAR items
A priori design? Y
Two independent reviewers? Y
Comprehensive literature search? Y
All publication types and languages N
included?
Included and excluded studies N
listed?
Study characteristics provided? Y
Study quality assessment Y
performed?
Study quality appropriately used in Y
analysis?
Appropriate statistical synthesis? Y
Publication bias assessed? N
Conflicts of interest stated? Y
DA = decision aid; N = no; PMID = PubMed identification numner; RCT = randomized controlled trial; UI = unique identifier; Y = yes.

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