Evidence map›Paper›PMID 17545350›Full record

Trial reportQuality & safety in health care2007

A patient decision aid to support shared decision-making on anti-thrombotic treatment of patients with atrial fibrillation: randomised controlled trial.

Richard G Thomson, Martin P Eccles, I Nick Steen, Jane Greenaway, Lynne Stobbart, Madeleine J Murtagh, Carl R May

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Quality & safety in health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 17 pooled it
7.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 17 syntheses or guidelines pooled it, 139 citations in OpenAlex.

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  4. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
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  6. Decision coaching for people making healthcare decisions.The Cochrane database of systematic reviews · 2021
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  11. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Richard G ThomsonInstitute of Health and Society, University of Newcastle upon Tyne, Newcastle upon Tyne, UK. richard.thomson@newcastle.ac.uk
Martin P Eccles
I Nick Steen
Jane Greenaway
Lynne Stobbart
Madeleine J Murtagh
Carl R May
Newcastle University · GB

Funding

Wellcome TrustWellcome Trust 065131Wellcome Trust 068380
6 · The paper itself

Abstract

objectiveTo determine the efficacy of a computerised decision aid in patients with atrial fibrillation making decisions on whether to take warfarin or aspirin therapy.

designTwo-armed open exploratory randomised controlled trial.

settingTwo research clinics deriving participants from general practices in Northeast England.

participants109 patients with atrial fibrillation aged over 60.

interventionsComputerised decision aid applied in shared decision-making clinic compared to evidence-based paper guidelines applied as direct advice.

main outcome measuresPrimary outcome measure was the decision conflict scale. Secondary outcome measures included anxiety, knowledge, decision-making preference, treatment decision, use of primary and secondary care services and health outcomes.

resultsDecision conflict was lower in the computerised decision aid group immediately after the clinic; mean difference -0.18 (95% CI -0.34 to -0.01). Participants in this group not already on warfarin were much less likely to start warfarin than those in the guidelines arm (4/16, 25% compared to the guidelines group 15/16, 93.8%, RR 0.27, 95% CI 0.11 to 0.63).

conclusionsDecision conflict was lower immediately following the use of a computerised decision aid in a shared decision-making consultation than immediately following direct doctor-led advice based on paper guidelines. Furthermore, participants in the computerised decision aid group were significantly much less likely to start warfarin than those in the guidelines arm. The results show that such an approach has a positive impact on decision conflict comparable to other studies of decision aids, but also reduces the uptake of a clinically effective treatment that may have important implications for health outcomes.

Indexed as

Decision Making, Computer-AssistedAgedAnticoagulantsAnxietyAspirinAtrial FibrillationConflict, PsychologicalDecision Support Systems, ClinicalEnglandFemaleFibrinolytic AgentsGamblingHumansLogistic ModelsMalePatient Education as TopicAnticoagulantsAspirinFibrinolytic AgentsWarfarin

Identifiers

PMID17545350
PMCPMC2464985
OpenAlexW2130573461

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.