Implications for practice and research
AIDS
We highlight four main implications of our study that should be addressed in future research and clinical practice:
First, high certainty of the evidence is needed to construct decision aids that aim to improve informed decision-making. This is especially important and challenging when there is equipoise regarding the efficacy of alternative treatments. Hence, more studies with larger sample sizes are needed to assess women’s values and preferences for the use of LMWH in pregnancy, thus providing high quality evidence to develop SDM interventions.Second, we highlight the importance of including components that specifically explore patients’ values and preferences, such as value elicitation exercises, to reduce decisional conflict. Simple exercises exploring factors such as their previous experience with the condition or treatment, should be included in the development of SDM interventions.Third, decision analysis has the potential to add value by reducing uncertainty and improving the efficacy and satisfaction with the SDM process. The cognitive reasoning activity of balancing pros and cons could be eased by an algorithm (decision analysis) that combines preferences with evidence. More implementation research is needed on how to deliver the decision analysis recommendation in clinical practice.Fourth, it is essential to assess the interaction between patient and health professional, as well as include health professionals in the development of SDM tools [