Limitations
One of the limitations of this study is that patients have to be able to use a computer with internet access to use the web-based DA and to complete the online questionnaires for the study. Thus, the group of patients for whom the online aspect of the DA is a disadvantage is already excluded. This might have resulted in a more positive result in the DA group. Second, clinicians who are less positive about SDM might have been less motivated to participate in the study and might have included fewer patients. As we hypothesise that SDM is important in improving the satisfaction with information and care, this is the group in particular where improvement can be made. Even though we included clinicians on a hospital level, bias was not completely avoidable. Furthermore, the targeted sample size for this study was not reached, because of the COVID-19 pandemic, and so the study did not have adequate power to show small but possibly significant differences between the two groups. During the pandemic, the elective care was downgraded and fewer patients with POP consulted a clinician. Thereafter, the DA became publicly available and a risk of bias arose. The already high scores on the questionnaires concerning patient satisfaction with information and treatment decision making may have resulted in a ceiling effect on the outcome measures.