JMIR Publications

ABSTRACT

Background:

Increasing prenatal screening options and limited consultation time have made it difficult for pregnant women to participate in shared decision making. Interactive digital decision aids (IDDAs) could integrate interactive technology into healthcare to facilitate higher-quality decision-making process.

Objective:

The objective of this study was to assess the effectiveness of IDDAs on pregnant women’s decision-making regarding prenatal screening.

Methods:

We searched CENTRAL, MEDLINE, Embase, PsycINFO, WHO ICTRP, Google Scholar, and reference lists of included studies until August, 2021. We included the randomized controlled trials (RCTs) that compared the use of IDDAs (fulfilling basic criteria of International Patient Decision Aid Standards Collaboration and were interactive and digital) as an adjunct to standard care with standard care alone and involved pregnant women themselves in prenatal screening decision-making. Data on primary outcomes, i.e., knowledge and decisional conflict, and secondary outcomes were extracted and meta-analyses were conducted based on standardized mean differences (SMDs). Subgroup analysis based on knowledge was performed. The Cochrane risk-of-bias tool was used for risk of bias assessment.

Results:

Eight RCTs were identified from 10283 references, of which seven were included in quantitative synthesis. Analyses showed that IDDAs increased knowledge (SMD 0.58, 95% CI 0.26 to 0.90) and decreased decisional conflict (SMD -0.15, 95% CI -0.25 to -0.05). Substantial heterogeneity in knowledge was identified, which could not be completely resolved through subgroup analysis.

Conclusions:

IDDAs can improve certain aspects of decision-making in prenatal screening among pregnant women, but the results require cautious interpretation. Clinical Trial: NA