Evidence map›Paper›PMID 40211416›Full record

ArticleImplementation science communications2025

Time required to implement a computerized patient decision aid for lupus in outpatient visits.

Nathan W Carroll, Aizhan Karabukayeva, Larry R Hearld, Diane Kamen, Alfred H J Kim, Sonali Narain, Narender Annapureddy, Zineb Aouhab, Maureen McMahon, Vikas Majithia and 3 more

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In one paragraph

Article in Implementation science communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Observational
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

13 authors.

Nathan W CarrollDepartment of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA.
Aizhan KarabukayevaHudson College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
Larry R HearldDepartment of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.
Diane KamenMedical University of South Carolina (MUSC), Charleston, SC, USA.
Alfred H J KimWashington University School of Medicine, St. Louis, MO, USA.
Sonali NarainNorthwell Hospital, Long Island, NY, USA.
Narender AnnapureddyVanderbilt University, Nashville, TN, USA.
Zineb AouhabLoyola University, Chicago, IL, USA.
Maureen McMahonUniversity of California at los Angeles (UCLA), Los Angeles, CA, USA.
Vikas MajithiaUniversity of Mississippi Medical Center, Jackson, MS, USA.
Cathy Lee ChingUniversity of Mississippi Medical Center, Jackson, MS, USA.
Winn ChathamUniversity of Nevada, Las Vegas, NV, USA.
Jasvinder A SinghBaylor College of Medicine, 7200 Cambridge Street, Houston, TX, 77030, USA. Jasvinder.md@gmail.com.ORCID http://orcid.org/0000-0003-3485-0006

Funding

Washington University Rheumatic DiseasesResearch Resource-based CenterP30AR073752 · NIAMS · WASHINGTON UNIVERSITY · PI Alfred Hyoungju Kim · 2018 to 2026
$7.6M
NIAMS NIH HHS P30 AR073752Patient-Centered Outcomes Research Institute SDM-2017C2-8224U.S. Department of Veterans Affairs AlabamaU.S. Department of Veterans Affairs resourcesU.S. Department of Veterans Affairs the use of facilities at the VA Medical Center at BirminghamU.S. Department of Veterans Affairs USA
6 · The paper itself

Abstract

backgroundPatient decision aids have the potential to lower decision conflict for patients and to improve patient-physician communication. However, uptake of decision aids has been poor, in part because the time required to incorporate these into clinical practice is not well understood.

objectiveTo estimate the time required for a rheumatology clinic to implement a validated decision aid for patients with lupus.

methodsUsing a cohort of eight implementation sites, study investigators identified the activities required to administer a decision aid. Site coordinators embedded within the clinics timed the duration of each activity. To estimate the effect of viewing the decision aid on the length of the physician-patient interaction, patient visits were timed and the length of visits for patients who viewed the decision aid were compared with visit lengths for three groups of control patients.

resultsEstimates of the effect of the decision aid on patient visit lengths ranged from a reduction of 3 min per visit to an increase of 3.88 min per visit, with five out of six estimates suggesting the decision aid is associated with shorter patient visits. Introducing the decision aid to patients took a mean of 4.12 min (median of 2 min). Identifying patients eligible for the decision aid was a weekly or bi-weekly process for most clinics and took an average of 41.43 min.

conclusionThe time required for a rheumatology clinic to implement the decision aid for patients with lupus is low. Our results raise questions about why decision aid take up is low among clinical practices, given the benefits the lupus decision aid offers to patients (reduced decisional conflict and better-informed choice of immunosuppressive medications used for the treatment of lupus kidney disease). More research is needed to identify barriers to decision aid adoption.

Indexed as

Decision aidDoctor-patient interactionMedical decision makingPatient centered carePatient participationShared decision-makingSystemic lupus erythematosus

Identifiers

PMID40211416
PMCPMC11987190

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