Methodological Research on the Adaptation of Patient Decision Support Tools: A Scoping Review (Preprint)

UNSTRUCTURED Objective: This scoping review aims to summarize the steps for adapting patient decision aids (PDAs) based on current research and to explore related methodologies. Methods: A systematic search of the PubMed, Cochrane Library, EMBASE, CINAHL, Web of Science, CNKI, WANFANG, VIP, and SinoMed databases and grey literature was conducted up to January 2024. The search terms focused on patient decision aids and their adaptation. The results were integrated through statistical and thematic analysis. Results: Twenty-five studies were included. Eight steps for adapting PDAs were identified, including defining decision problems and options; assessing local cultural backgrounds; translating; adjusting PDA language style, content, and presentation; creating an initial version of the PDA; conducting acceptability testing; conducting feasibility testing; and PDA revisions. Only a few studies followed a rigorous process for adapting PDAs, and most research did not undertake steps such as local cultural background assessment and feasibility testing due to challenges related to sample size acquisition, cultural diversity, and complexity. Conclusion: This study focused on the steps of language style, content, presentation adjustment, and acceptability testing in the overall process of formulating the steps for adapting decision support tools, adapting these tools, and identifying specific methods for acceptability testing. This study enhanced the quality assessment indicators for PDA language style, content, and presentation adjustments to provide a reference for subsequent research. However, gaps still exist in the evaluation standards for the language style, content, and presentation of PDAs that should be addressed by future research.