Discussion
Motamedi-Azari
AIDS
In this patient-centered study of prosthodontic consultations, two different PDAs were compared for overall patient satisfaction and its constituent quality criteria. Compared to a control group not involving the use of a PDA, a statistically significant impact was demonstrable in a group involving the additional use of a software-based PDA during the consultations. Also, the results in this group were more favorable, including some statistically significant differences, than the results in a group involving the use of a paper-based PDA. Both null hypotheses underlying the study were therefore rejected.While the mean ratings were, again, consistently more favorable in this latter group (paper-based PDA) than in the control group (no PDA), none of these differences was found to be statistically significant. This relative closeness of intergroup findings is less surprising when considering that all consultations, including those in the control group, were carried on with a focus on meeting the criteria of “shared decision-making” [Despite this aforementioned lack of statistical significance, it should be noted that the general trend of ratings for overall patient satisfaction was clearly more favorable with the paper-based PDA (test group 1) than without a PDA (control group). In particular, the ratings for “different options were adequately presented” and “sequence of treatment was adequately explained” came fairly close to the ratings in test group 2 involving a software-based PDA (see Table In orthodontics, Marshman et al. [Nevertheless, the feeling among patients that additional aids would have been helpful was reduced in both PDA groups, and significantly so in test group 2 (software-based PDA) compared to the control group. Hence an active desire for a PDA does seem to exist on the patients’ part. It should also be considered, however, that not all patients are equally keen to play an active role in shared decision-making. Motamedi-Azari et al. [The highest levels of overall satisfaction with the prosthodontic consultations in the present study were reported in test group 2 (software-based PDA), even though the advantage over test group 1 (paper-based PDA) was not found to be statistically significant. Of course, any PDA that is used to complement a consultation session needs to include information about the clinical problem at hand, available treatment options, treatment outcomes, and examples for demonstration [Visualizing case-specific scenarios is a hallmark of advanced technologies, one example being the “digital smile design” process, which educates patients by allowing them to view their own situation [Several limitations of the present study should be mentioned. Firstly, any knowledge gained by the patients through the use of either PDA may be surmised from their ratings but was not assessed by objective criteria. Conclusions to this effect, which could be drawn from knowledge levels noted after versus before the consultations, are beyond the scope of this report. Also, the study did not factor in prosthetic treatment requirements, states of prosthetic restoration, or histories of treatment, given that past experiences might affect the outcomes of shared decision-making in prosthodontics [Lastly, the questionnaire used in the study was not an established questionnaire, and its test–retest reliability was not investigated. Its content was, however, highly intelligible to all patients, and the authors are not aware of any other existing questionnaire that could have been harnessed or adapted to assess the usefulness of PDAs in prosthodontics. Also, the questionnaire had been pre-tested for clinical usability in a reference group of ten patients.