ObjectiveTo review and compare the efficacy of different delivery modes of decision aids (DAs), including computer‐based, print‐based, multimedia‐based, video‐based, and website‐based on decision‐making outcomes for prostate cancer screening compared to usual care (UC) and among the delivery modes.MethodsPubMed, the Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Advanced Search, and Turning Research Into Practice (TRIP) Database were systematically searched from inception to August 2023. The primary outcomes were knowledge level, knowledge scores, participation in shared decision‐making (SDM), decisional conflict, and preference for SDM participation. Secondary outcomes were the proportion of subjects who underwent screening (actual screening utilisation) and the proportion of subjects who intended to be screened (intention to undergo screening). Network and pairwise meta‐analyses were performed using random‐effects models.ResultsSeven systematic reviews were included. Network meta‐analysis found that multimedia (relative risk [RR] 1.51, 95% confidence interval [CI] 1.02–2.24), print (RR 1.82, 95% CI 1.23–2.69), and website‐based (RR 1.99, 95% CI 1.32–3.01) DAs significantly increased participation in SDM compared to the computer‐based DA. There was a significant reduction in the actual screening utilisation in the computer DA arm compared to the other delivery modes. No significant differences between all delivery modes were noted on knowledge levels, knowledge scores, decisional conflict, preference for SDM participation, and intention to undergo screening. The highest mean surface under the cumulative ranking curve for all primary outcomes showed that website‐based was the most effective delivery mode, followed by print‐based DA. The pairwise meta‐analysis showed a significant increase in participants’ knowledge level, knowledge scores, a reduced intention to undergo screening and actual screening utilisation compared to UC.ConclusionsThe findings suggest that different types of DAs have varying levels of effectiveness in increasing knowledge level, knowledge scores, participation in SDM, and influencing screening behaviours. While website‐based DA appeared the most effective, employing the print‐based DA could be a practical solution in settings with limited resources.

中文翻译：

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决策辅助实施模式在前列腺癌筛查中的疗效：伞式评价和网状荟萃分析


目的回顾和比较不同决策辅助 （DAs） 交付模式的疗效，包括基于计算机、基于印刷、基于多媒体、基于视频和基于网站的决策结果，与常规护理 （UC） 和交付模式相比。方法系统检索了从建库到 2023 年 8 月的 PubMed、Excerpta Medica 数据库 （EMBASE）、护理和相关健康文献累积索引 （CINAHL） 、Google 高级搜索和将研究转化为实践 （TRIP） 数据库。主要结局是知识水平、知识评分、参与共同决策 （SDM）、决策冲突和对 SDM 参与的偏好。次要结局是接受筛查的受试者比例 （实际筛查利用率） 和打算接受筛查的受试者比例 （打算接受筛查）。使用随机效应模型进行网络和成对荟萃分析。结果共纳入 7 篇系统评价。网络荟萃分析发现，与基于计算机的 DA 相比，多媒体 （相对风险 [RR] 1.51,95% 置信区间 [CI] 1.02-2.24）、印刷品 （RR 1.82,95% CI 1.23-2.69） 和基于网站 （RR 1.99,95% CI 1.32-3.01） 的 DA 显着增加了对 SDM 的参与。与其他给药模式相比，计算机 DA 组的实际筛选利用率显著降低。所有交付模式在知识水平、知识评分、决策冲突、对 SDM 参与的偏好和接受筛选的意图方面均未观察到显著差异。 所有主要结局的累积排名曲线下的最高平均表面显示，基于网站的交付模式是最有效的交付模式，其次是基于印刷的 DA。成对荟萃分析显示，与 UC 相比，参与者的知识水平、知识分数、接受筛查的意愿降低和实际筛查利用率显着增加。结论研究结果表明，不同类型的 DAs 在提高知识水平、知识分数、参与 SDM 和影响筛查行为方面具有不同的有效性水平。虽然基于网站的 DA 似乎最有效，但在资源有限的环境中，采用基于印刷的 DA 可能是一个实用的解决方案。