OBJECTIVES

: The concept of shared decision making (SDM), a collaborative approach between patients and physicians based on evidence-based information and patients’ informed preferences, is gaining prominence in oncology. Decision aids (DAs) are frequently used to facilitate greater patient engagement in the treatment selection process while providing physicians with information regarding patient preferences. Therefore, the current study objective was to conduct a systematic literature review identifying DAs and associated outcomes within oncology care.

METHODS

: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was conducted across English-language publications from January 2007 to November 2017 searching PubMed, EBSCO Medline, CINAHL, Scopus, and Cochrane Library databases. Review articles, thesis/dissertations, commentaries, editorials or summary reports on the topic were excluded. Included articles were evaluations of DAs (in the forms of tools/instruments) utilized in cancer care that assessed some form of outcome.

RESULTS

: A total of 1150 articles were identified, of which 25 studies were eligible based on the inclusion/exclusion criteria. A total of 14 (56%) of the studies were conducted outside of the US, including 3 (12%) studies each in Canada and the Netherlands. The most common cancers that were evaluated with DAs were breast (14; 56%) and prostate (7; 28%). A variety of DA formats were utilized, including printed materials (10; 40%), software/websites (10; 40%), videos (2; 8%) and others (3; 12%). Common outcomes evaluated with the DAs were patient acceptability, knowledge, feasibility and decisional conflict/attributes. A minority of DAs (4; 16%) were evaluated using prospective, controlled studies while the majority consisted of surveys and qualitative evaluations.

CONCLUSIONS

: A variety of DA tools/instruments have been evaluated for use in oncology care, albeit with lower quality evidence to support their use. Further work should focus on testing DAs against standards of care to fully determine their value in SDM.