决策辅助工具在慢性肾脏病患者肾脏替代治疗决策中应用效果的Meta分析

Effectiveness of decision aids on decision-making for renal replacement therapy in patients with chronic kidney disease:a meta-analysis

目的系统评价患者决策辅助工具在慢性肾脏病患者肾脏替代治疗决策中的应用效果。方法计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方数据库,获取有关慢性肾脏病决策辅助的文献,检索时限为建库至2023年12月。使用RevMan 5.4软件分析数据。结果共纳入12篇文献,研究结果表明使用决策辅助工具能够提高患者的决策知识水平(MD=2.29,95%CI:1.18~3.39,P<0.001)、降低患者的决策冲突(MD=-0.69,95%CI:-1.09~-0.29,P<0.001),改善决策质量。结论决策辅助工具有助于改善患者的决策行为,提高决策质量,后续需要更多研究进一步检验其在辅助决策中的效果。

Objective Systematic evaluation of the effectiveness of patient decision aids on decisionmaking for renal replacement therapy in patients with chronic kidney disease.Methods Computerized searches for Web of Science,PubMed,Cochrane Library,Embase,China Knowledge,and Wanfang databases were conducted to obtain literature about decision aids for chronic kidney disease,with a timeframe from the time of construction to December 2023.Data were analyzed using Review Manager 5.4 software.Results A total of 12 articles were obtained.Analyses of the articles showed that the use of decision aids can increase patients'decision knowledge(MD=2.29,95%CI:1.18~3.39,P<0.001),reduce patients'decision conflict(MD=−0.69,95%CI:−1.09~−0.29,P<0.001),and improve decision quality.Conclusion Decision aids can improve patients'decision-making behavior and enhance decision-making quality.Further studies are needed to assess the assistant effectiveness of decision-making for renal replacement therapy.