Cochrane · systematic review · CD013385
Decision coaching for people making healthcare decisions
Jull, J, Köpke, S, Smith, M, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Consumers and CommunicationAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
30
current version
GRADE rated
22
No studies
8
Included studies
NR
No studies 8 · 26.7%Ungraded 0 · 0%Very low 19 · 63.3%Low 3 · 10%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Comparison #1: Decision coaching versus usual care ‐ Summary of findings
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Preparation for decision‐making scale (Bennett 2010) (higher scores = feeling more prepared). Measured: Post‐consultation (Shepherd 2019) Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | 1 study · 110 participants | Very low Downgraded: risk of bias, imprecision |
Decision self‐confidence: Decision self‐efficacy scale (O'Connor 1995): range 0 (no self‐efficacy) to 100 (perfect self‐efficacy). Measured: Post‐consultation (Hacking 2013; Shepherd 2019) (Analysis 1.1) Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | 2 studies · 201 participants | Very low Downgraded: risk of bias, imprecision |
Feeling uniformed Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | NR | No studies |
Unclear values Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | NR | No studies |
Feeling unsupported Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | NR | No studies |
Knowledge tests: Standardised on score from 0 (no knowledge) to 100 (perfect knowledge) Measured using different knowledge tests: post‐intervention (Green 2001) or one month (Matloff 2006) post‐intervention (Analysis 1.2) Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | 2 studies · 97 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects: Decision Regret Scale (Brehaut 2003): Standardised on score from 0 to 100 (none to worst regret) measured 3 (Shepherd 2019) and 6 months (Hacking 2013) post‐consultation Comparison #1: Decision coaching vs usual care ‐ Summary of findings | 2019 | 2 studies · 170 participants | Very low Downgraded: risk of bias, imprecision |
Hospital Anxiety and Depression (HAD) Scale (Zigmond 1983) Measured 3 months post‐consultation (Shepherd 2019) and 6 months (Hacking 2013) post‐intervention. Matloff 2006 measured worry about cancer 6 months post‐intervention (Diefenbach 1999) and... Comparison #1: Decision coaching vs usual care ‐ Summary of findings | no estimate extracted | 2 studies · 175 participants | Very low Downgraded: risk of bias, imprecision |
Comparison #2: Decision coaching versus evidence‐based information ‐ Summary of findings
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Preparation for decision‐making Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | NR | No studies |
Decision self‐confidence: Empowerment scale (McAllister 2011): Standardised on score from 0 to 100 (none to highest efficacy) measured 1 week post‐intervention (Adam 2019) Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 106 participants | Very low Downgraded: risk of bias, imprecision |
Feeling uninformed subscale of Decisional conflict Scale (O'Connor 1995b) measured post‐consultation (Deschamps 2004) Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 91 participants | Very low Downgraded: risk of bias, imprecision |
Unclear values Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | NR | No studies |
Feeling unsupported Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | NR | No studies |
Knowledge tests: Standardised on score from 0 to 100 (none to perfect) knowledge Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | 3 studies · 406 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects: State and Trait Anxiety Inventory (Spielberger 1983): Standardised score from 0 to 100 (none to worst anxiety) measured post‐ intervention (Hunter 2005) Comparison #2: Decision coaching vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 242 participants | Low Downgraded: risk of bias, imprecision |
Comparison #3: Decision coaching plus evidence‐based information versus usual care ‐ Summary of findings
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Preparation for decision‐making scale (Bennett 2010): standardised scored from 0 to 100 (none to highest prepared) measured one month post‐intervention (Brown 2019) Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Decision self‐confidence: Decision self‐efficacy scale (O'Connor 1995): range 0 to 100 (none to perfect self‐efficacy) measured 12 weeks post‐intervention (McBride 2016) Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Feeling uninformed subscale of Decisional Conflict Scale (O'Connor 1995b): standardised scored 0‐100 (lower score indicates feeling more informed) measured post‐intervention and post‐consultation (Analysis 3.1). A fourth study (Col 2007) measured ... Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 3 studies · 212 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Unclear values subscale of Decisional Conflict Scale (O'Connor 1995b): standardised scored 0‐100 (lower scores indicate feeling clearer values) measured post‐intervention or post‐consultation (Analysis 3.2). A fourth study (Col 2007) measured chan... Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | SMD 0.02 | 3 studies · 212 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Feeling unsupported subscale of Decisional Conflict Scale (O'Connor 1995b) standardised scored 0‐100 (lower score indicates feeling more supported) measured post‐intervention or post‐consultation (Analysis 3.3). A fourth study (Col 2007) measured ... Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 3 studies · 212 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Knowledge tests: Standardised on score from 0 to 100 (none to perfect knowledge), using various knowledge tests. Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 5 studies · 1073 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: Decision Regret Scale (Brehaut 2003) (Brown 2019; McBride 2016) Other DecisionRegret (Clark 1997), (Mishel 2009). Measured at up to 3 months post‐intervention Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 3 studies · 250 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
State and Trait Anxiety Inventory (Spielberger 1983) (Davison 1997; Kennedy 2002; Van Peperstraten 2010). Measured post‐intervention (Van Peperstraten 2010), 6 weeks post‐consultation (Davison 1997), and 12 months post‐consultation (Kennedy 2002).... Comparison #3: Decision coaching plus evidence‐based information vs usual care ‐ Summary of findings | no estimate extracted | 4 studies · 1017 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Comparison #4: Decision coaching plus evidence‐based information versus evidence‐based information ‐ Summary of findings
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Preparation for decision‐making Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | NR | No studies |
Decision self‐confidence Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | NR | No studies |
Feeling uninformed subscale of Decisional Conflict Scale (O'Connor 1995b) standardised scored 0 to 100 (lower score indicate feeling more informed) change in score from baseline measured 2 weeks post‐consultation (Col 2007) Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 67 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Unclear values subscale of Decisional Conflict Scale (O'Connor 1995b) standardised scored 0 to 100 (lower scores indicate feeling more clear values) change in score from baseline measured post 2 weeks post‐consultation (Col 2007) Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 67 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Feeling unsupported subscale of Decisional Conflict Scale (O'Connor 1995b) standardised scored 0 to 100 (lower score indicates feeling more supported) change in score from baseline measured 2 weeks post‐consultation (Col 2007) Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | 1 study · 67 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Knowledge tests: Standardised on score from 0 to 100 (none to perfect knowledge) Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | SMD 0.18 | 3 studies · 573 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects: State and Trait Anxiety Inventory (Spielberger 1983): (Kennedy 2002). Hospital Anxiety and Depression Scale (Zigmond 1983) (Rahn 2018). Measured 2 weeks post‐intervention to 12 months post‐consultation Comparison #4: Decision coaching plus evidence‐based information vs evidence‐based information ‐ Summary of findings | no estimate extracted | 2 studies · 340 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |