Aim Shared decision-making is recommended for patients considering treatment options for severe aortic stenosis (AS) and chronic coronary artery disease (CAD). This review aims to systematically identify and assess patient decision aids (PtDAs) for chronic CAD and AS and evaluate the international evidence on their effectiveness for improving the quality of decision-making. Methods and Results Five databases (Cochrane, CINAHL, Embase, MEDLINE, PsycInfo), clinical trial registers and 30 PtDA repositories/websites were searched from 2006 to March 2023. Screening, data extraction and quality assessments were completed independently by multiple reviewers. Meta-analyses were conducted using Stata statistical software. Eleven AS and 10 CAD PtDAs were identified; seven were less than five years old. Over half the PtDAs were web-based and the remainder paper-based. One AS and two CAD PtDAs fully/partially achieved international PtDA quality criteria. Ten studies were included in the review; four reported on the development/evaluation of AS PtDAs and six on CAD PtDAs. Most studies were conducted in the USA with White, well-educated, English-speaking participants. No studies fulfilled all quality criteria for reporting PtDA development and evaluation. Meta-analyses found that PtDAs significantly increased patient knowledge compared to ‘usual care’ (mean difference:0.620; 95%CI 0.396, 0.845, p < 0.001) but did not change decisional conflict. Conclusion Patients who use PtDAs when considering treatments for AS or chronic CAD are likely to be better informed than those who do not. Existing PtDAs may not meet the needs of people with low health literacy levels as they are rarely involved in their development.

中文翻译：

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主动脉瓣狭窄和慢性冠状动脉疾病的患者决策辅助：系统回顾和荟萃分析

目标 建议考虑严重主动脉瓣狭窄 (AS) 和慢性冠状动脉疾病 (CAD) 治疗方案的患者共同决策。本综述旨在系统地识别和评估慢性 CAD 和 AS 的患者决策辅助 (PtDA)，并评估其在提高决策质量方面的有效性的国际证据。方法与结果 2006年至2023年3月检索​​了5个数据库（Cochrane、CINAHL、Embase、MEDLINE、PsycInfo）、临床试验注册库和30个PtDA存储库/网站。筛选、数据提取和质量评估由多名审稿人独立完成。使用Stata统计软件进行荟萃分析。鉴定出 11 个 AS 和 10 个 CAD PtDA；七人不到五岁。超过一半的 PtDA 是基于网络的，其余的是基于纸质的。1 个 AS 和 2 个 CAD PtDA 完全/部分达到国际 PtDA 质量标准。审查中纳入了十项研究；其中四份报告了 AS PtDA 的开发/评估，六份报告了 CAD PtDA。大多数研究是在美国进行的，参与者都是受过良好教育、讲英语的白人。没有研究满足报告 PtDA 开发和评估的所有质量标准。荟萃分析发现，与“常规护理”相比，PtDA 显着增加了患者知识（平均差：0.620；95%CI 0.396、0.845，p < 0.001），但没有改变决策冲突。结论 在考虑治疗 AS 或慢性 CAD 时使用 PtDA 的患者可能比不使用 PtDA 的患者更了解情况。现有的 PtDA 可能无法满足健康素养水平较低的人群的需求，因为他们很少参与其发展。