Table 1:

Characteristics of the included studies

Study, year of publication Country	Design	Randomisation	Setting	Clinicians	Health care question addressed	Intervention	Control
Coylewright, 201613 USA (RCT) Coylewright, 201714 (nested study)	2-arm parallel RCT, single centre Nested qualitative study (semi-structured interviews)	At patient level Out of 36 clinicians, 24 had DA encounters and 25 had usual care encounters	Hospital-based outpatient cardiology practices (general and interventional cardiology clinic)	RCT: n=36 Interventional cardiologist, non-invasive cardiologists, physician assistant, cardiac catheterization laboratory physician Extenders Interview study: n=13	Choose between optimal medical therapy and percutaneous coronary intervention (in stable coronary artery disease)	PCI (percutaneous coronary intervention) Choice DA.	Usual care
Hess, 201615 USA	2-arm parallel RCT, multicentre	At patient level 436 post visit clinician surveys completed in DA group and 430 in usual care group	Emergency Departments	n=361 Emergency clinicians (emergency physicians, nurse practitioners, and physician assistants)	Choose between admission for observation and further cardiac testing (cardiac stress testing or coronary computed tomography angiography) or referral for outpatient evaluation (in patients with low risk chest pain)	Chest Pain Choice DA	Usual care
Hess, 2012 16 USA	2-arm, parallel RCT single centre	At patient level	Emergency Department of tertiary care hospital	n=51 Physicians (including residents), physician-assistants, nurse practitioners	Choose between emergency department observation unit admission and urgent cardiac stress testing or follow-up with a physician within 72 hours (in patients with low risk chest pain)	Chest Pain Choice DA	Usual care
Perestelo-Pérez, 201617 Spain	2-arm parallel cluster RCT, multicentre	At clinician group level 15 clinicians in the DA group, 14 in the usual care group	Primary care centres	n=29 Physicians	Take a statin yes/no	Statin Choice DA	Usual care
Nannenga, 200918 USA	2-arm parallel RCT, single centre	At patient and clinician level	Subspecialty clinic for diabetes at tertiary hospital	n=16 Endocrinologists specializing in diabetes care (consultants and fellows)	Take a statin yes/no	Statin Choice DA	Standard patient education pamphlet
Thomson, 200719 United Kingdom	2-arm, parallel RCT, multicentre	At patient level	Two research clinics deriving patients from general practices	n=2 One doctor per clinic, trained in delivering either the DA or guidelines	Warfarin anticoagulation or aspirin treatment to reduce the risk of stroke (in patients with atrial fibrillation)	DARTS II (Decision Analysis in Routine Treatment II) DA	Paper-based guidelines (control)
Warner, 201520 USA	2-arm parallel RCT, single centre	At patient level Separate groups of clinicians delivered the decision aid (n = 18) and usual care (n = 6) to minimize the potential for contamination.	Preoperative evaluation centre at a tertiary hospital	n=24 Physician assistants, an internist, anaesthesiologists and anaesthesiology residents	Choose between three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good (in smokers evaluated in preparation for elective surgery	DA Smoking Cessation Around the Time of Surgery	Usual care
Mathers, 201221 United Kingdom (RCT) Brown, 201422 (nested study)	2-arm parallel cluster RCT, multicentre Nested mixed-methods study (interviewsand observations of consultations)	At clinician group/ practice level The nested study focused on eight encounters within the RCT	General practices (25 practices in the DA group, 24 in the control group)	n: not specified Patients’ primary care clinicians for diabetes care (general practitioner or practice nurse)	Start insulin (in patients with type 2 diabetes mellitus) yes/no	PANDAs (Patients ANd Decision Aids) DA	Usual care
Karagiannis, 201623 Greece	2-arm parallel cluster RCT, multicentre	At clinician group/ practice level 101 clinicians in DA group, 103 un usual care group	Primary and secondary care practices	n=204 Physicians, physician assistants, and nurse practitioners	Choose between different anti-hyperglycaemic drugs for treatment of type 2 diabetes mellitus	Diabetes Medication Choice DA	Usual care
Mullan, 200924 USA	2-arm cluster parallel RCT, multicentre	At clinician level 21 clinicians in the DA group, 19 clinicians in the control group	Primary care and family medicine sites	n=40 Physicians, physician assistants, and nurse practitioners	Choose between different anti-hyperglycaemic drugs for treatment of type 2 diabetes mellitus	Diabetes Medication Choice DA	Usual care
Denig, 201425 The Netherlands	2-arm parallel RCT, multicentre	At clinician group/ practice level for computer-based versus printed DA At patient level for DA versus control	General practices	n=25 Nurse practitioner, nurse, or specialised assistant for diabetes care	Set treatment goals in diabetes and choose treatment options of risk factors including: statin, angiotensin-converting enzyme (ACE) inhibitor, healthy life style	DA for prioritising treatment goals in diabetes	Usual care
LeBlanc, 2015 (Osteoporosis)26 USA	3-arm parallel RCT, multicentre	At patient level 22 clinicians administered DA, 28 clinicians were in the control group	Primary care practices	n=50 Physicians, physician-assistants, nurse practitioners	Take bisphosphonates yes/no	Osteoporosis Choice DA	1.Provision of the patient’s risk of fracture (obtained from FRAX calculator) only to the clinician Usual care
Montori, 201127 USA	2-arm parallel RCT, multicentre	At patient level Out of 60 clinicians, 39 administered DA, 33 administered usual care)	General medicine and primary care practices	n=60 Primary care clinicians	Take bisphosphonates yes/no	Osteoporosis Choice DA	2.Usual care
LeBlanc, 2015 (Antidepressants)28 USA	2-arm parallel cluster RCT, multicentre	At clinician group/ practice level 66 clinicians in DA group, 51 in usual care group)	Primary care practices	n=117 Clinicians (including residents)	In adults with moderate to severe depression: considering treatment with an antidepressant	Depression Medication Choice DA	Usual care
Loh, 200729 Germany	2-arm parallel cluster RCT, multicentre	At clinician level 20 clinicians in the DA group, 10 in the control group patients recruited by each physician were viewed as clusters	General practices associated as teaching practices with University Hospital	n=30 Primary care physicians	Choose between treatment options for newly diagnosed depression	Multi-faceted shared decision making program	Usual care
Légaré, 201230 Canada	2-arm parallel cluster RCT, multicentre	At clinician group/ practice level 77 clinicians in the DA group, 72 clinicians in the control group	Family practice teaching units (walk-in clinics)	n= 149 Family physicians, including physician teachers and residents Physicians who had participated in the DECISION+ trial were excluded.	Take antibiotics for acute respiratory infections yes/no	DECISION+2: multi-faceted shared decision making training program (modified from DECISION+)	Usual care
Légaré, 201131 Canada	2-arm parallel cluster RCT, multicentre	At clinician group/ practice level 18 clinicians in the DA group, 15 clinicians in the control group	Family medicine groups	n= 33 Family physicians	Take antibiotics for acute respiratory infections yes/no	DECISION+:multi-faceted shared decision making training program	DECISION+ participation delayed for 6 months
Anthierens, 201532 Belgium, England, Netherlands, Poland, Spain and Wales	Qualitative study (semi-structured interviews) nested in cluster RCT using a 2×2 factorial design, multicentre	At clinician group/ practice level 53 practices in DA group, 55 practices in usual care group 66 clinicians were interviewed in the nested study	General practices	n= 372 (total in all 3 arms) Physicians in primary care	Take antibiotics for acute respiratory infections yes/no	Training in enhanced communication skills for physicians and Interactive booklet on antibiotics for acute respiratory-tract infections for clinical encounter	Usual care (other arms, not analysed in our review included CRP group and DA+CRP group)
Walczak, 201733 Australia	2-arm parallel RCT, multicentre	At patient level, stratified by clinician. 1:1 balanced randomisation codes for each clinician.	Cancer treatment centres affiliated with major hospitals	Two senior nurses (one with palliative care background and one with emergency medicine background) had meetings with patients approximately one week before visits with an oncologist.	Discuss information regarding prognosis, end-of-life, future care, advance care planning (in patients with various advanced, incurable cancer diagnoses and an oncologist-assessed 2–12 month life expectancy	Nurse-led communication support program using a question prompt list	Usual care
Leighl, 201134 Australia, Canada	2-arm parallel RCT, international multicentre	At patient level, stratified by clinician.	Hospital-based outpatient cancer clinics	n=13 Medical oncologists with expertise in colorectal cancer	Take first-line (palliative) chemotherapy for metastatic colorectal cancer yes/no	Booklet with accompanying audiotape or compact disc for patients to take home	Usual care (standard medical oncology consultation)
Ozanne, 200735 USA	2-arm parallel RCT, single centre	At patient level	High-risk breast cancer prevention program, breast care centre prevention clinic at one university	n=4 Multidisciplinary group of physicians including surgeons, internists, and gynaecologists, all with expertise in breast cancer prevention	Choose between different breast cancer prevention options (for women at high risk of developing breast cancer)	DA for breast cancer prevention	Usual care
Whelan, 200336 Canada, USA	2-arm parallel RCT, international multicentre	At patient level	Regional cancer centres in Ontario and one general hospital in California	n=22 Medical oncologists	Take adjuvant chemotherapy in lymph node-negative breast cancer yes/no	“Decision Board”	Usual care
Bekker, 200437 United Kingdom	1-arm parallel RCT, single centre	At patient level	Hospital-based prenatal diagnosis clinic	n: not specified “The same professional delivered the routine and intervention consultations”	Choose between different options for prenatal diagnosis of Down syndrome (in women who had a screen-positive maternal serum screening test result for Down syndrome)	Integration of “prompts” (based on decision analysis methodology) into clinical encounter	Usual care (routine consultation without “prompts”)

DA: decision aid

ED: Emergency department

n: number

RCT: randomised controlled trial