Development and Evaluation of Shared Decision-Making Tools in Rheumatology: A Scoping Review

Introduction Shared decision-making (SDM) tools are facilitators of decision-making through a collaborative process between patients/caregivers and clinicians. These tools help clinicians understand patient's perspectives and help patients in making informed decisions based on their preferences. Despite their usefulness for both patients and clinicians, SDM tools are not widely implemented in everyday practice. One barrier is the lack of clarity on the development and evaluation processes of these tools. Such processes have not been previously described in the field of rheumatology. Objective To describe the development and evaluation processes of shared decision-making (SDM) tools used in rheumatology. Methods Bibliographic databases (e.g., EMBASE and CINAHL) were searched for relevant articles. Guidelines for the PRISMA extension for scoping reviews were followed. Studies included were: addressing SDM among adults in rheumatology, focusing on development and/or evaluation of SDM tool, full texts, empirical research, and in the English language. Results Of the 2030 records screened, forty-six reports addressing 36 SDM tools were included. Development basis and evaluation measures varied across the studies. The most commonly reported development basis was the International Patient Decision Aids Standards (IPDAS) criteria (19/36, 53%). Other developmental foundations reported were: The Ottawa Decision Support Framework (ODSF) (6/36, 16%), Informed Medical Decision Foundation elements (3/36, 8%), edutainment principles (2/36, 5.5%), and others (e.g. DISCERN and MARKOV Model) (9/31,29%). The most commonly used evaluation measures were the Decisional Conflict Scale (18/46, 39%), acceptability and knowledge (7/46, 15%), and the preparation for decision-making scale (5/46,11%). Conclusion For better quality and wider implementation of such tools, there is a need for detailed, transparent, systematic, and consistent reporting of development methods and evaluation measures. Using established checklists for reporting development and evaluation is encouraged.