23. Healthcare system effects.
| Study | Scale used | N decisionaid | Decision aid ‐ mean | N comparison | Comparison ‐ mean | Difference between groups | Notes |
| Consultation length | |||||||
| Bekker 2004 (in consultation) | Consultation length using DA in the consultation (minutes) | 50 | 32.2 (SD 13.0) | 56 | 26.3 (SD 11.5) | + 5.9 minutes | P = 0.01 (longer with decision aid) |
| Bozic 2013 | Consultation length with practitioner post‐DA (minutes) | 61 | 20.9 (SD 6.8) | 62 | 21.0 (SD 7.2) | −0.1 minutes | No difference; P = 0.91 |
| Krist 2007 | Time spent discussing prostate cancer with practitioner post‐DA (minutes) ‐ patient reported | 196 | 5.3 | 75 | 5.2 | + 0.1 minutes | No difference between groups |
| Time spent discussing prostate cancer with practitioner post‐DA (minutes) ‐ physician reported | 196 | 3.8 | 75 | 4.2 | −0.4 minutes | No difference between groups but physicians thought they spent less time than patients (P < 0.001) | |
| LeBlanc 2015 (in consultation) | Consultation length with practitioner using DA in consultation (median, range in minutes) | 29 | 11.5 (5.4 to 21.4) | 37 | 10.7 (2.5 to 54.9) | + 0.8 minutes (−33.6 to 3.0) | — |
| Loh 2007 (in consultation) | Consultation length using DA in consultation (minutes) | 191 | 29.2 (10.7) | 96 | 26.7 (12.5) | +2.5 minutes | P = 0.681 |
| Ozanne 2007 (in consultation) | Consultation length using DA in consultation (minutes) | 15 | 24 | 15 | 21 | +3 minutes | P = 0.42 |
| Thomson 2007 (in consultation) | Consultation length using DA in consultation (minutes) | 8 | 44 (39 to 55) | 10 | 21 (19 to 26) | +23 minutes | P = 0.001 Compared computerized decision aid with standard gamble within the consultation to guideline driven consultation |
| Vodermaier 2009 | Consultation length with practitioner post‐DA | ||||||
| 5 to 10 min | 53 | 6 (11.3%) | 54 | 5 (9.3%) | — | P = 0.91 | |
| 10 to 15 min | 17 (32.1%) | 19 (35.2%) | — | ||||
| 15 to 25 min | 15 (28.3%) | 14 (25.9%) | — | ||||
| 25 to 35 min | 7 (13.2%) | 5 (9.3%) | — | ||||
| Above 35 min | 8 (15.1%) | 11 (20.4%) | — | ||||
| Whelan 2003 (in consultation) | Consultation length using DA in consultation (minutes) | 50 | 68.3 | 50 | 65.7 | + 2.6 minutes | P = 0.53 |
| Weymiller 2007 (in consultation) | Consultation length using DA in consultation (minutes) | 52 | — | 46 | — | + 3.8 minutes in DA group | Not statistically significant 3.8 min (95% CI −2.9 to 10.5) |
| Cost and resource use | |||||||
| Hollinghurst 2010; Montgomery 2007 | Total costs in the UK for decision about mode of delivery post previous cesarean | 235 | GBP 2019 (SD 741) | 238 | GBP 2033 (SD 677) | — | No difference |
| Kennedy 2002 | Cost‐effectiveness in the UK for decision about benign heavy menstruation | 296 300 |
USD 2026 (DA alone) USD 1556 (DA plus nurse coaching |
298 | USD 2751 | — | Mean differences: DA versus usual care USD 461 (95% CI 236 to 696) DA plus coaching versus usual care USD 1184 (95% CI 684 to 2110) |
| Murray 2001a | Total costs excluding intervention in the UK for decision about treatment of benign enlarged prostate | 57 | GBP 310.3 (SD 602.0) | 48 | GBP 188.8 (SD 300.4) | — | Mean difference GBP 121.5 (95% CI −58.9 to 302.0) |
| Total costs including intervention (interactive video disk equipment) in the UK for decision about treatment of benign enlarged prostate | 57 | GBP 594.10 (SD 602) | 48 | GBP 188.8 (SD 300.4) | — | Mean difference GBP 405.4 (95% CI GBP 224.9 to GBP 585.8) P < 0.001 |
|
| Murray 2001b | Total costs excluding intervention in the UK for decision about hormone replacement therapy | 85 | GBP 90.5 | 84 | GBP 90.9 (SD 39.2) | — | No difference |
| Total costs including intervention (interactive video disk equipment) in the UK for decision about hormone replacement therapy | 85 | GBP 306.5 (SD 42.8) | 84 | GBP 90.9 (SD 39.2) | — | Mean difference GBP 215.5 (95% CI 203.1 to 228.0) P < 0.001 | |
| Van Peperstraten 2010 | Mean total savings per couple in the Netherlands for decision about embryo transfer for invitro fertilization | — | — | — | — | — | Mean total saving per couple in the intervention group were EUR 169.75 (USD 219.12) |
| Vuorma 2003 | Total estimated costs in Finland for treatment decision about heavy benign menstruation | 184 | EUR 2760 | 179 | EUR 3094 | — | P = 0.1 No difference between intervention and control |
| Resource use | |||||||
| Legare 2012 (in consultation) | Repeat consultation for the same reason, n (%) | 163 | 37 (22.7%) | 165 | 25 (15.2%) | Absolute difference 7.5 | RR 1.3 (95% CI 0.7 to 2.3) |
| Thomson 2007 (in consultation) | GP consultations postintervention | 51 | 39 (76.5%) | 54 | 32 (59.3%) | — | P = 0.35 |
| Hospital appointments postintervention | 51 | 29 (56.9%) | 54 | 10 (18.5%) | — | P = 0.06 | |
| Wait time from screening of eligibility to decision | |||||||
| Stacey 2014a | Wait time in weeks | 69 | 33.4 weeks | 71 | 33 weeks | — | No difference |
CI: confidence interval; DA: decision aid; RR: risk ratio; SD: standard deviation.