Randomised trial comparing an interactive multimedia decision aid with a leaflet and a video to give information about prenatal screening for Down syndrome

“…Fewer women were undecided at first follow up (relative risk [RR] 0.42, 95% CI 0.24-0.74) 6,27,28 or regretted their decision (RR 0.58, 95% CI 0.35-0.97) 6,17 and a greater proportion of women felt that they had enough information to make their decision when they were informed with a DA (RR 2.88, 95% CI 2.02-4.10). 6,18,27 Most studies looking at satisfaction found a nonsignificant positive effect of DAs on satisfaction with decision, 8,18,22 , decision-making process, 18 and experience with birth and pregnancy. 19 Kupperman et al 17 found a significant difference in satisfaction with decision-making process at first follow up (scale 0-10, DA 8.1 versus control 7.5; P < 0.001).…”

Section: Other Secondary Outcomesmentioning

confidence: 99%

Decision aids to improve informed decision‐making in pregnancy care: a systematic review

Vlemmix

Warendorf

Rosman

et al. 2012

BJOG

120

104

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Background Rapid development in health care has resulted in an increasing number of screening and treatment options. Consequently, there is an urgency to provide people with relevant information about benefits and risks of healthcare options in an unbiased way. Decision aids help people to make decisions by providing unbiased non-directive research evidence about all treatment options.Objective To determine the effectiveness of decision aids to improve informed decision making in pregnancy care.Search strategy We searched MEDLINE (1953-2011), EMBASE (1980-2011, CENTRAL (CENTRAL, the Cochrane Library; 2011, Issue 4), Psycinfo (1806Psycinfo ( -2011 and Research Registers of ongoing trials (www.clinicaltrials.gov, www.controlled-trials.com).Selection criteria We included randomised controlled trials comparing decision aids in addition to standard care. The study population needed to be pregnant women making actual decisions concerning their pregnancy.Data collection and analysis Two independent researchers extracted data on quality of the randomised controlled trial (GRADE criteria), quality of the decision aid (IPDAS criteria), and outcome measures. Data analysis was undertaken by assessing group differences at first follow up after the interventions.Main results Ten randomised controlled trials could be included. Pooled analyses showed that decision aids significantly increased knowledge, (weighted mean difference 11.06, 95% confidence interval 4.85-17.27), decreased decisional conflict scores (weighted mean difference À3.66, 95% confidence interval À6.65 to À0.68) and decreased anxiety (weighted mean difference À1.56, 95% confidence interval À2.75 to À0.43).Conclusions Our systematic review showed the positive effect of decision aids on informed decision making in pregnancy care. Future studies should focus on increasing the uptake of decision aids in clinical practice by identifying barriers and facilitators to implementation.

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“…Decision aids offer information (such as decision options and probabilities of different outcomes), examples of othersÕ decision-making experiences, and guidance on decision-making steps. 36 Several decision aids have been developed for prenatal testing 30,[37][38][39][40] and have been found to promote informed choices and ⁄ or reduce decisional conflict. 30,37,38 In the context of prenatal testing, our results suggest that decision aids should consider values that encompass moral views and beliefs rather than simply preferences for particular outcomes.…”

Section: Implications For Policy and Service Provisionmentioning

confidence: 99%

Exploring informed choice in the context of prenatal testing: findings from a qualitative study

Potter

O'Reilly

Etchegary

et al. 2008

Health Expectations

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Purpose This study explored whether and how a sample of women made informed choices about prenatal testing for foetal anomalies; its aim was to provide insights for future health policy and service provision.Methods We conducted semi-structured interviews with 38 mothers in Ottawa, Ontario, all of whom had been offered prenatal tests in at least one pregnancy. Using the Multi-dimensional Measure of Informed Choice as a general guide to analysis, we explored themes relevant to informed choice, including values and knowledge, and interactions with health professionals.Results Many, but not all, participants seemed to have made informed decisions about prenatal testing. Values and knowledge were interrelated and important components of informed choice, but the way they were discussed differed from the way they have been presented in scientific literature. In particular, ÔvaluesÕ related to expressions of womenÕs moral views or ideas about Ôhow life should be livedÕ and ÔknowledgeÕ related to the ways in which women prioritized and interpreted factual information, through their own and othersÕ experiences and in Ôthinking throughÕ the personal implications of testing. While some women described non-directive discussions with health professionals, others perceived testing as routine or felt pressured to accept it.Conclusions Our findings suggest a need for maternity care providers to be vigilant in promoting active decision making about prenatal testing, particularly around the consideration of personal implications. Further development of measures of informed choice may be necessary to fully evaluate decision support tools and to determine whether prenatal testing programmes are meeting their objectives.

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Randomised trial comparing an interactive multimedia decision aid with a leaflet and a video to give information about prenatal screening for Down syndrome

Abstract: The use of IMDA did not affect the women's overall uptake rate of the prenatal screening test for Down syndrome. More women less than 35 years accepted IMDA probably because they used computer more frequently and had more computer knowledge.

Cited by 34 publications

References 11 publications

Providing information about prenatal screening for Down syndrome: a systematic review

Providing information about prenatal screening for Down syndrome: a systematic review

Decision aids to improve informed decision‐making in pregnancy care: a systematic review

Exploring informed choice in the context of prenatal testing: findings from a qualitative study

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