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Syst Rev. 2017 Mar 15;6(1):56. doi: 10.1186/s13643-017-0446-2.

Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

Author information

1
Department of Family and Emergency Medicine, Laval University, Pavillon Ferdinand-Vandry, Room 2881, 1050 Avenue de la Médecine, Quebec city, QC, G1V 0A6, Canada.
2
Quebec Excellence Center on Aging, St-Sacrement Hospital, Room L2, 1050, chemin Sainte-Foy, Quebec city, QC, G1S 4L8, Canada.
3
Research Centre on Primary Health Care and Services of Laval University, Quebec City, Canada.
4
CHU de Québec Research Centre, Quebec City, QC, Canada.
5
St. Francois d'Assise Hospital, 10, rue de l'Espinay, Quebec city, QC, Room 2122-Z, 1050 Avenue de la Médecine, Quebec City, QC, G1L 3L5, Canada.
6
Faculty of Nursing Sciences, Laval University, Quebec City, QC, Canada.
7
University Laval Faculty of Pharmacy, Quebec City, Canada.
8
McGill University Department of Family medicine, 5858 Côte-des-Neiges, Suite 300, Room 328, Montreal, QC H3S 1Z1, Canada.
9
Department of Family and Emergency Medicine, Laval University, Pavillon Ferdinand-Vandry, Room 2881, 1050 Avenue de la Médecine, Quebec city, QC, G1V 0A6, Canada. anik.giguere@fmed.ulaval.ca.
10
Quebec Excellence Center on Aging, St-Sacrement Hospital, Room L2, 1050, chemin Sainte-Foy, Quebec city, QC, G1S 4L8, Canada. anik.giguere@fmed.ulaval.ca.
11
Research Centre on Primary Health Care and Services of Laval University, Quebec City, Canada. anik.giguere@fmed.ulaval.ca.
12
CHU de Québec Research Centre, Quebec City, QC, Canada. anik.giguere@fmed.ulaval.ca.

Abstract

BACKGROUND:

Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers.

METHOD:

We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision. We gave priority to higher quality evidence (e.g., systematic reviews). For each DB, we first identified secondary sources of literature, namely, clinical summaries, clinical practice guidelines, and systematic reviews. After an initial extraction, we searched for primary studies in academic databases and grey literature to fill gaps in evidence. We extracted study designs, sample sizes, populations, and probabilities of benefits/harms of the health options. A single reviewer conducted the literature search and study selection. The data extracted by one reviewer was verified by a second experienced reviewer. Two reviewers assessed the quality of the evidence. We converted all probabilities into absolute risks for ease of understanding. Two to five experts validated the content of each DB. We conducted descriptive statistical analyses on the review processes and resources required.

RESULTS:

The approach allowed screening of a limited number of references (range: 104 to 406/review). For each review, we included 15 to 26 studies, 2 to 10 health options, 11 to 62 health outcomes and we conducted 9 to 47 quality assessments. A team of ten reviewers with varying levels of expertise was supported at specific steps by an information specialist, a biostatistician, and a graphic designer. The time required to complete a rapid review varied from 7 to 31 weeks per review (mean ± SD, 19 ± 10 weeks). Data extraction required the most time (8 ± 6.8 weeks). The average estimated cost of a rapid review was C$11,646 (SD = C$10,914).

CONCLUSIONS:

This approach enabled the development of clinical tools more rapidly than with a traditional systematic review. Future studies should evaluate the applicability of this approach to other teams/tools.

KEYWORDS:

Costs; Decision support technology; Evidence summary; Knowledge tools; Knowledge translation; Patient decision aid; Policy; Rapid review; Scoping review

PMID:
28298241
PMCID:
PMC5353791
DOI:
10.1186/s13643-017-0446-2
[Indexed for MEDLINE]
Free PMC Article

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