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      Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist

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          Abstract

          Background

          Patient decision aids (PDAs) are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. The International Patient Decision Aid Standards (IPDAS) Collaboration review papers and Cochrane systematic review of PDAs have found significant gaps in the reporting of evaluations of PDAs, including poor or limited reporting of PDA content, development methods and delivery. This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating PDAs.

          Methods

          An international workgroup, consisting of members from IPDAS Collaboration, followed established methods to develop reporting guidelines for PDA evaluation studies. This paper describes the results from three completed phases: (1) planning, (2) drafting and (3) consensus, which included a modified, two-stage, online international Delphi process. The work was conducted over 2 years with bimonthly conference calls and three in-person meetings. The workgroup used input from these phases to produce a final set of recommended items in the form of a checklist.

          Results

          The SUNDAE Checklist (Standards for UNiversal reporting of patient Decision Aid Evaluations) includes 26 items recommended for studies reporting evaluations of PDAs. In the two-stage Delphi process, 117/143 (82%) experts from 14 countries completed round 1 and 96/117 (82%) completed round 2. Respondents reached a high level of consensus on the importance of the items and indicated strong willingness to use the items when reporting PDA studies.

          Conclusion

          The SUNDAE Checklist will help ensure that reports of PDA evaluation studies are understandable, transparent and of high quality. A separate Explanation and Elaboration publication provides additional details to support use of the checklist.

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          Most cited references18

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          CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials.

          The CONSORT (Consolidated Standards of Reporting Trials) statement is used worldwide to improve the reporting of randomized, controlled trials. Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.
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            Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide.

            Without a complete published description of interventions, clinicians and patients cannot reliably implement interventions that are shown to be useful, and other researchers cannot replicate or build on research findings. The quality of description of interventions in publications, however, is remarkably poor. To improve the completeness of reporting, and ultimately the replicability, of interventions, an international group of experts and stakeholders developed the Template for Intervention Description and Replication (TIDieR) checklist and guide. The process involved a literature review for relevant checklists and research, a Delphi survey of an international panel of experts to guide item selection, and a face to face panel meeting. The resultant 12 item TIDieR checklist (brief name, why, what (materials), what (procedure), who provided, how, where, when and how much, tailoring, modifications, how well (planned), how well (actual)) is an extension of the CONSORT 2010 statement (item 5) and the SPIRIT 2013 statement (item 11). While the emphasis of the checklist is on trials, the guidance is intended to apply across all evaluative study designs. This paper presents the TIDieR checklist and guide, with an explanation and elaboration for each item, and examples of good reporting. The TIDieR checklist and guide should improve the reporting of interventions and make it easier for authors to structure accounts of their interventions, reviewers and editors to assess the descriptions, and readers to use the information.
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              A systematic development process for patient decision aids

              Background The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it. Methods Our review drew on three sources: a) published papers describing PtDAs evaluated in randomised controlled trials and included in the most recent Cochrane Collaboration review; b) linked papers cited in the trial reports that described how the PtDAs had been developed; and c) papers and web reports outlining the development process used by organisations experienced in developing multiple PtDAs. We then developed an extended model of the development process indicating the various steps on which documentation is required, as well as a checklist to assess the frequency with which each of the elements was publicly reported. Results Key features common to all patient decision aid (PtDA) development processes include: scoping and design; development of a prototype; ‘alpha’ testing with patients and clinicians in an iterative process; ‘beta’ testing in ‘real life’ conditions (field tests); and production of a final version for use and/or further evaluation. Only about half of the published reports on the development of PtDAs that we reviewed appear to have been field tested with patients, and even fewer had been reviewed or tested by clinicians not involved in the development process. Very few described a distribution strategy, and surprisingly few (17%) described a method for reviewing and synthesizing the clinical evidence. We describe a model development process that includes all the original elements of the original IPDAS criterion, expanded to include consideration of format and distribution plans as well as prototype development. Conclusions The case for including each of the elements outlined in our model development process is pragmatic rather than evidence-based. Optimal methods for ensuring that each stage of the process is carried out effectively require further development and testing.
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                Author and article information

                Journal
                BMJ Qual Saf
                BMJ Qual Saf
                qhc
                bmjqs
                BMJ Quality & Safety
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-5415
                2044-5423
                May 2018
                21 December 2017
                : 27
                : 5
                : 380-388
                Affiliations
                [1 ] departmentDivision of General Internal Medicine , Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts, USA
                [2 ] departmentFaculty of Health Sciences and Sport , University of Stirling , Stirling, UK
                [3 ] departmentDepartment of Health Services Research , University of Texas MD Anderson Cancer Center , Houston, Texas, USA
                [4 ] departmentLeeds Institute of Health Sciences , University of Leeds , Leeds, UK
                [5 ] departmentDepartment of Family Medicine and Emergency Medicine , Universite Laval Faculte de medecine , Quebec, Canada
                [6 ] departmentDepartment of Research , Healthwise Inc , Boise, Idaho, USA
                [7 ] departmentPublic Health Sciences , University of Virginia School of Medicine , Charlottesville, Virginia, USA
                [8 ] departmentHealth Sciences and Psychological Sciences , University of Missouri , Columbia, Missouri, USA
                [9 ] The Reaching for High Value Care Team , Chapel Hill, North Carolina, USA
                [10 ] departmentOttawa Hospital Research Institute , University of Ottawa , Ottawa, Ontario, Canada
                [11 ] departmentSchool of Nursing , University of Ottawa , Ottawa, Ontario, Canada
                [12 ] departmentHealth Evidence , Radboud University Nijmegen Medical Center , Nijmegen, The Netherlands
                [13 ] departmentDivision of General Internal Medicine , Massachusetts General Hospital , Boston, Massachusetts, USA
                [14 ] departmentCollege of Nursing , Ohio State University , Columbus, Ohio, USA
                [15 ] Institute of Health and Society, Newcastle University , Newcastle upon Tyne, UK
                Author notes
                [Correspondence to ] Dr Karen R Sepucha, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA; ksepucha@ 123456mgh.harvard.edu
                Article
                bmjqs-2017-006986
                10.1136/bmjqs-2017-006986
                5965362
                29269567
                699e7b57-bf86-450c-abf8-22fad84042fd
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 01 June 2017
                : 21 September 2017
                : 31 October 2017
                Funding
                Funded by: Shared Decision Making Collaborative of the Duncan Family Institute for Cancer Prevention and Risk Assessment at the University of Texas MD Anderson Cancer Center;
                Funded by: FundRef http://dx.doi.org/10.13039/100000133, Agency for Healthcare Research and Quality;
                Funded by: United Kingdom Health Foundation;
                Categories
                Research and Reporting Methodology
                1506
                Custom metadata
                unlocked

                Public health
                shared decision making,patient-centred care,checklists,patient education
                Public health
                shared decision making, patient-centred care, checklists, patient education

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