ReviewMedical decision making : an international journal of the Society for Medical Decision Making2021
What Works in Implementing Patient Decision Aids in Routine Clinical Settings? A Rapid Realist Review and Update from the International Patient Decision Aid Standards Collaboration.
Review in Medical decision making : an international journal of the Society for Medical Decision Making, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 9 of them syntheses that pooled 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.
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.
Who cites it
121 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- A systematic review of patient decision aids for hypertension.BMC medical informatics and decision making · 2026Pooled it
- Effects of patient decision aids used pre-consult or in-consult on patient-clinician communication - secondary analysis of a systematic review with meta-analysis.BMC medical informatics and decision making · 2025Pooled it
- Feasibility and Efficacy of Decision Aids to Improve Decision-Making for Contralateral Prophylactic Mastectomy: A Systematic Review.Annals of surgical oncology · 2025Pooled it
- Lung cancer screening completion among patients using decision aids: a systematic review and meta-analysis.Cancer causes & control : CCC · 2025Pooled it
- The Effect of Patient Decision Aid Attributes on Patient Outcomes: A Network Meta-Analysis of a Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Pooled it
- Use of digital patient decision-support tools for atrial fibrillation treatments: a systematic review and meta-analysis.BMJ evidence-based medicine · 2025Pooled it
- Decisional needs and interventions for young women considering contraceptive options: an umbrella review.BMC women's health · 2024Pooled it
- Decision aids for cancer survivors' engagement with survivorship care services after primary treatment: a systematic review.Journal of cancer survivorship : research and practice · 2024Pooled it
- A decision aid to support family carers of people living with dementia towards the end-of-life: Coproduction process, outcome and reflections.Health expectations : an international journal of public participation in health care and health policy · 2021Pooled it
- Providing information to prepare breast cancer patients for their surgical consultation: barriers and recommendations (an analysis from Alliance A231701CD).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Experiences Implementing a Suite of Decision Aids for Implantable Cardioverter Defibrillators: Qualitative Insights From the DECIDE-ICD Trial.Circulation. Cardiovascular quality and outcomes · 2022Trial
- Patient and Clinician Decision Support to Increase Genetic Counseling for Hereditary Breast and Ovarian Cancer Syndrome in Primary Care: A Cluster Randomized Clinical Trial.JAMA network open · 2022Trial
- Development and piloting of four decision aids for implantable cardioverter-defibrillators in different media formats.Pacing and clinical electrophysiology : PACE · 2021Trial
- Accessibility and Decision-Supportive Quality of Benign Breast Disease Articles on Chinese Hospital WeChat Public Accounts: Nationwide Cross-Sectional Study.JMIR medical informatics · 2026Article
- Feasibility, acceptability, and usability of a patient decision aid for participation in the DAHANCA 35 proton radiotherapy trial: A qualitative study.Technical innovations & patient support in radiation oncology · 2026Article
- Prioritizing Equity in Design and Implementation of Consumer-Facing Digital Resources to Support Engagement and Shared Decision-Making.Journal of medical Internet research · 2026Article
- Development, Co-Design and Pilot Testing of Resources to Support Informed Decision-Making for Lung Cancer Screening in Australia: A Study Engaging Diverse Communities and Expert Healthcare Professionals.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Logic Models on Health Information Technology-Related Interventions: Scoping Review Across Disciplines.JMIR medical informatics · 2026Article
- Initial development and usability testing of a digital fertility preservation navigator for newly diagnosed young adult cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Modified Decisional Conflict Scale for Primary Caregivers in Long-Term Care Facilities: Psychometric Validation Using Structural Equation Modeling.Healthcare (Basel, Switzerland) · 2026Article
61 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecades of effectiveness research has established the benefits of using patient decision aids (PtDAs), yet broad clinical implementation has not yet occurred. Evidence to date is mainly derived from highly controlled settings; if clinicians and health care organizations are expected to embed PtDAs as a means to support person-centered care, we need to better understand what this might look like outside of a research setting.
aimThis review was conducted in response to the IPDAS Collaboration's evidence update process, which informs their published standards for PtDA quality and effectiveness. The aim was to develop context-specific program theories that explain why and how PtDAs are successfully implemented in routine healthcare settings.
methodsRapid realist review methodology was used to identify articles that could contribute to theory development. We engaged key experts and stakeholders to identify key sources; this was supplemented by electronic database (Medline and CINAHL), gray literature, and forward/backward search strategies. Initial theories were refined to develop realist context-mechanism-outcome configurations, and these were mapped to the Consolidated Framework for Implementation Research.
resultsWe developed 8 refined theories, using data from 23 implementation studies (29 articles), to describe the mechanisms by which PtDAs become successfully implemented into routine clinical settings. Recommended implementation strategies derived from the program theory include 1) co-production of PtDA content and processes (or local adaptation), 2) training the entire team, 3) preparing and prompting patients to engage, 4) senior-level buy-in, and 5) measuring to improve.
conclusionsWe recommend key strategies that organizations and individuals intending to embed PtDAs routinely can use as a practical guide. Further work is needed to understand the importance of context in the success of different implementation studies.
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Registered trials
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.