Table 4.
Summary of qualitative findings on the consult decision aid about alendronate as a treatment option for osteoporosis
| Categories | Comments/suggestions | Response |
|---|---|---|
| Plain language | Use plain language (e.g., harm–benefit ratio, contraindications, decline) | Changed to simpler words |
| Alendronate ‘may’ … is unclear | No change because this is accurate information | |
| Remove ‘reasons to’ | No change; features are not always benefits | |
| Unsure if all will understand the information | No change; for use in the consultation | |
| Unclear what ‘best estimate’ means | Added hyperlink to more information | |
| Print size | Add more space | Added more space on internet version |
| Enlarge font for GRADE rating | No change; information is for the clinician | |
| Enlarge font overall | No change; can modify font with browser settings | |
| Make footer easier to read | Changed color from gray to black font | |
| Logical layout/format | Need printable version | Electronic and paper versions are planned |
| Improve designs for images | Images to be improved during publishing | |
| X in ‘decline the option’ is too strong | X used for years in DAs; changed color/font of X to balance with other icons | |
| Move ‘SURE test’ sooner | No change; selecting kept after comparing options | |
| Write from patient perspective (e.g. ‘I’ instead of ‘you’) | No change; for use in the consultation | |
| Clarity of information provided | GRADE should be explained | Added more details in a hyperlink |
| Unclear for ‘how much does this matter’ | Added ‘to you’ | |
| Osteopenia does not equal osteoporosis | Removed osteopenia as it was not necessary | |
| Missing information | Interaction with other drugs | Added to list of other information to consider |
| Long-term use of medicine: benefits/harms, changes in side effects over time | Added to list of other information to consider | |
| Significance of harms and outcomes | Added to list of other information to consider | |
| Confidence intervals | No change; not necessary for IPDAS criteria | |
| Allergies | Added to list of other information to consider | |
| Cochrane and development of DA | Added in user manual | |
| More information on side effects | Added to list of other information to consider | |
| Full list of options | Identified as a limitation | |
| List of questions to discuss with doctor | Added based on other information to consider | |
| Too much information | If they have osteoporosis, do you need description in Part I | Required by IPDAS but not necessary to go through in a consult; added in manual on how to use it |
| Need for data entry: if they are doing it with the doctor, why write it down? | For values clarification, it is better if the tool is interactive; made explicit in user manual | |
| Remove references | Required by IPDAS criteria; remained as hyperlink | |
| Instructions | Be more explicit on how to use the links | Added to user manual and provided blue underlines |
| Provide instructions on using it | Added in user manual |
DA decision aid, IPDAS International Patient Decision Aid Standards