Computerised decision aids: a systematic review of their effectiveness in facilitating high-quality decision-making in various health-related contexts

Patient Educ Couns. 2012 Jul;88(1):69-86. doi: 10.1016/j.pec.2011.11.006. Epub 2011 Dec 18.


Objective: To systematically review existing empirical evidence regarding the effectiveness of computerised decision aids (CDAs) in enabling high-quality decision-making in preference-sensitive health-related contexts.

Methods: Relevant studies were identified via Medline, CINAHL, and PsycINFO databases (1990-October 2010). Only randomised controlled trials with at least one decision quality or decision process variable outcome were included.

Results: Of 1467 identified articles, 28 studies met all inclusion criteria, evaluating 26 unique CDAs. CDAs performed better than standard consultations/education regarding improved knowledge and lower decisional conflict, and were found not to increase anxiety. CDAs facilitated greater satisfaction with the decision-making process than standard education. The effects on risk perceptions, value congruence with the chosen option, preferred roles in decision-making and decisional self-efficacy need further evaluation. A paucity of CDAs adhered to decision theories.

Conclusions: CDAs showed similar effects as non-computerised DAs on various outcomes. Further research into the potentially superior effects of CDAs on feeling informed, values-clarity, and decisional conflict is required.

Practice implications: The more remarkable effects on knowledge and risk perceptions were reported when unique features of interactive computerised media were used. The potential benefit of tailored information, values-clarification, and integration of CDAs into shared decision-making consultations remains unresolved.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Decision Making, Computer-Assisted*
  • Decision Support Techniques*
  • Health Knowledge, Attitudes, Practice
  • Health Status
  • Humans
  • Patient Participation
  • Patient Satisfaction
  • Self Efficacy