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A Scoping Review of Decision Support Tools for Patients with Lower Extremity Arterial Disease: Towards Shared-Decision Making

Annie X. Yu, Joel B. Ding,Alun H. Davies,Leonard L. Shan

Annals of Vascular Surgery(2024)

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Abstract
Objective In recent years, decision support tools in various fields of medicine have emerged to aid clinicians and patients in the process of shared-decision making. This scoping review aims to identify the existing decision support tools for selecting treatments in lower extremity arterial disease and to evaluate their effectiveness in facilitating shared-decision making. Methods The PRISMA guidelines for scoping reviews were followed. A literature search was conducted across MEDLINE, EMBASE and Cochrane databases, along with the Decision Aid Library Inventory, for studies published between Jan 2000 and June 2023. Articles reporting the development and/or clinical application of a decision support tool specific to lower extremity arterial disease were included. A narrative synthesis of the results was performed and findings were presented in tabular formats. Results Five studies and five unique decision support tools were included. Presenting formats included websites, booklets, brochures and pocket cards. Overall, a high degree of heterogeneity was observed across all decision support tools in their format, content and delivery. A widespread acceptability and satisfaction were reported amongst patients and clinicians. However, their effect at improving shared decision-making remains uncertain due to the lack of standardised outcome metrics. Conclusion The development and implementation of decision support tools for lower limb arterial disease treatment discussion remain in early stages. This review lays the foundation for future studies to continue exploring optimal strategies for decision support tool development and their role in supporting shared-decision making.
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Key words
Shared-decision making,Decision support tools,Lower extremity arterial disease
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