Measuring healthcare decision aid effectiveness

Knowledge on the causes, prevention, screening, diagnosis, treatment and progression of disease is increasing exponentially in both volume and complexity. Clinicians and patients need to assimilate this information to make decisions in situations of prognostic uncertainty and healthcare decision aids may help this process by providing all the information (even if conflicting) in one place and/or by aiding values clarification. Like all healthcare interventions, decision aids must be evaluated before introduction into the patient pathway to ensure they provide benefit, avoid harm, and achieve their aims. Published evaluations vary in outcome measures resulting in difficulty in comparisons and limiting progress in this field. This paper reviews the literature and proposes a framework to guide the evaluation of decision aids in healthcare.