Video-based patient decision aids: A scoping review

Accepted Manuscript Title: Video-Based Patient Decision Aids: A Scoping Review Authors: Karin Winston, Petra Grendarova, Doreen Rabi PII: DOI: Reference:

S0738-3991(17)30585-2 https://doi.org/10.1016/j.pec.2017.10.009 PEC 5810

To appear in:

Patient Education and Counseling

Received date: Revised date: Accepted date:

21-4-2017 6-10-2017 16-10-2017

Please cite this article as: Winston Karin, Grendarova Petra, Rabi Doreen.VideoBased Patient Decision Aids: A Scoping Review.Patient Education and Counseling https://doi.org/10.1016/j.pec.2017.10.009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Title: Video-Based Patient Decision Aids: A Scoping Review Karin Winston, MDa, Petra Grendarova, MDb, Doreen Rabi, MDc a

Alberta Children’s Hospital

2800 Shaganappi Trail NW Calgary, Alberta Canada

2

T3B 6A8

University of Calgary, Division of Radiation Oncology

Calgary, Canada 3

University of Calgary, Department of Medicine

Calgary, Canada

Corresponding Author: Karin Winston, MD FRCPC #150, 1620 29 St NW Calgary, AB Canada

T2N4L7

Phone: 403-284-0440 Fax: 403-282-3223 [email protected]

Highlights   

Videos are steadily gaining popularity for use in patient education and decision making and are generally considered to be beneficial. Most videos are studied in small populations for a limited number of decisions. The mechanism by which videos are helpful is not yet fully understood.

Abstract Objective: This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. Method: The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. Results: 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. Conclusion: Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. Practice Implications: Clinicians should consider incorporating videobased DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids. Key Words: decision aids, video, media, decision-making

Introduction Decision aids (DA) are “tools designed to help people participate in decision-making about health care options. They provide information on the options and help patients clarify and communicate the personal value they associate with different features of the options” [1]. DA may be composed of static pictures, questionnaires, videos, interactive computer programs, or a combination of several components. The intent is to generate discussion for the purpose of clarifying a patient’s preference for a particular medical procedure or willingness to engage in future health care decisions such as screening for disease or accessing available health care services. Most studies to this point focus on decision aids targeting immediate health care decisions [2], but DA could be valuable in areas such as advanced care planning in which patients may be asked to predict what they would choose given a particular health circumstance [3]. These studies may also be done on healthy people acting as surrogates for patients by asking them to imagine themselves in a given situation. Health care professionals can then try to tailor an intervention that may be used at an emotionally difficult time, such as genetic screening or gender assignment in cases of infantile genital ambiguity [4]. DA may be used as complete, stand-alone interventions or as supplements to provider communications, particularly for making complex decisions. Multiple studies have been done to evaluate the effectiveness of DA. The majority focused on how well decision aids increased patient knowledge or determined their acceptability to patients. The most recent update of the Cochrane Review of randomized control trials of decision aids for people facing health treatment or screening decisions [2] concluded that people exposed to decision aids feel more

knowledgeable, better informed, and clearer about their values. They likely are more active in decision making and more accurately perceive risk. DA may increase the likelihood that patient choices are congruent with their values and have not shown adverse outcomes. 105 studies were ultimately included for analysis in the most recent review, but because Cochrane reviews exclusively evaluate randomized controlled trials, most study types are excluded from their evaluation. Other types of studies can add important outcomes, which have not been evaluated by randomized trials. Qualitative studies, for example, can provide valuable information regarding the underlying mechanism(s) of effective decision aids, and what components make a particular intervention successful. Small observational studies show that pilot projects are being implemented in a particular area for a particular decision. Successful pilots could be expected to influence what material is subsequently developed and used for the broader population. Areas with several small pilots that do not show benefit, for example, may explain why larger studies in that particular area are not done. Therefore, reviews that limit the evaluation of decision aids to randomized controlled trials focused on efficiency may overlook other potential benefits, i.e. patient satisfaction and care efficiency. Videos as a means of communication have likewise been increasingly used over the last 20 years [5]. Videos may be helpful for patients with lower levels of literacy since they do not depend on reading comprehension for the acquisition of information [6,7]. They can also be widely distributed over the internet or via internal networks, allowing a single production to be used multiple times at minimal recurring costs [8]. Also, visual information could be more useful to patients making complex decisions as it may enable them to more realistically envision contexts or outcomes [3]. Finally, videos may be more appealing to younger patients who have grown up using various types of multimedia as vital sources of information [9-12]. At a time when health care costs are a priority concern and organizations are seeking to maximize returns on investments, video-based interventions for patient decision-making may also be a way to standardize counselling related to decision-making and potentially to replace some of the education time that is often spent by health care providers. If video interventions are as effective as personal contact, this would represent a cost-effective way to deliver some portions of the health visit that would then allow providers to focus on other aspects of care. Additionally, videos could be used to prepare patients prior to their visits to optimize use of health care time. As interest grows in the development and use of videos for patient decision-making, it is important to know what areas of medicine and what effects have previously been evaluated to understand what has been effective in the past, and to direct future material development. In this study, we examined all the available published evidence on the use of pre-produced videos whose primary aim was to assist patients in making medical decisions. We did not evaluate the use of videos in the assessment of other decision aids or in the assessment of medical providers.

Methods Protocol and Information Sources

With the assistance of a medical librarian, a search strategy was determined that would be sufficiently broad to capture all relevant citations. Search strategies were piloted to ensure that known relevant literature was included and strategies broadened when necessary to capture known key publications. The protocol for this search was not registered. Searches were performed in Medline, EMBASE, PsychInfo, and CINAHL from the initiation of the databases to the end of December 2016. Handsearching of the journals Patient Education and Counseling and Medical Decision Making was also performed, and references of included studies were cross-referenced to identify any additional sources. The search strategy is outlined in Table 1. Eligibility Criteria Studies were included for full text review if they contained original data and the study included the use of a pre-produced video, a medically relevant behavioural outcome, and evidence of patient choice. Exclusion criteria were: the use of live broadcasts, including videoconferencing and live television; exclusively static presentations such as Powerpoint; interactive visual aids such as video games; outcomes restricted to knowledge or attitude change or unrelated to patient choice (such as intraoperative blood pressure); or correct use of a medical device. Review studies that did not include original research and publications that were not peer reviewed, including conference abstracts and theses, were also excluded. Figure 1 illustrates the workflow in processing the studies. Study selection Not all authors describe their intervention in sufficient detail to determine whether the media presentation used would meet the above criteria. To be as inclusive as possible, at the risk of including some interventions that would not strictly be considered DA, we considered eligible all studies that described the inclusion of a pre-produced video for the purpose of assisting a patient or surrogate in making a medical decision. Data collection process After performing database searches, citations were exported to RefWorks and duplicates were eliminated. Due to the large number of citations, KW and PG independently reviewed batches of 100 citations in duplicate to ensure that similar criteria were being applied by both researchers. Once the agreement between researchers was > 90%, the remaining titles and abstracts were divided between the two and reviewed independently for appropriateness for full text review. Citations were referred for full text review if the title and/or abstract contained any of the key words and implied that the study might be relevant to the search. An example of an excluded study would be on the use of video-guided fluoroscopic procedures, containing the key word “video” but clearly irrelevant to this project. Studies whose title and/or abstract met the study criteria were subjected to full text review by both reviewers. Extracted data included the following variables: year of publication, country in which the research was conducted, number of participants, gender and age of participants, study design, area of medicine, decision of interest, whether the video was the only intervention used or one component in a larger intervention, and the overall effect of the video on patients’ decision-making (positive, negative,

neutral, or undetermined) as described by the authors of the article. Data extraction was done independently in duplicate with the results compared to ensure agreement between the researchers. Disagreements in data extraction were resolved by consensus between the researchers. Synthesis of results Data were collected and synthesized by KW using Excel. Decisions regarding what analyses to perform were agreed upon by both researchers and carried out by KW for collective review.

Results Description of published studies A total of 488 studies were included in the final analysis. Most studies had sample sizes under 300 (68%), with 264 out of 488 (54%) including fewer than 200 people, and of these 157/488 (32%) included fewer than 100 people. Considering that many of these studies had at least two groups for comparison, the number of patients who were exposed to the experimental condition was relatively small. The distribution of sample sizes across the studies is largely skewed towards fewer participants, which might be expected where local pilot or validation studies are being performed. Figure 2 shows the distribution of studies by number of participants. Most studies assessed adult participants, with 87% of studies exclusively conducted on adults, and 3.1% including both adults and children. Figure 3 demonstrates the relative proportions of each group. The majority of studies (69%) included both male and female participants as shown in Figure 4. Some of the studies, by nature of the subject matter, were necessarily restricted to one sex, such as those addressing breastfeeding or prostate cancer. Since breast cancer, Pap smear screening, and breastfeeding were commonly studied areas, it is not surprising that 23% of the studies included female participants only. Outcome of Interest Decisions were divided into the following groups based on type of decision within a particular area of medicine: screening, treatment adherence, or treatment decision. Examples of decisions related to screening include decisions to undergo a mammogram, colonoscopy, or HIV testing in an asymptomatic person. Whether a decision is considered adherence or treatment preference depends on the perspective of the authors or the reader. For the purpose of this analysis, standard prescribed treatment for a diagnosed condition such as diabetic self-care or correct use of post-operative spirometry was defined as treatment adherence. Decisions related to primary prevention such as risk reduction and vaccinations, or where there is no applicable standard of care, such as degree of desired participation in health care, were considered treatment preference. Specifically, smoking and breastfeeding, while medically recommended, were categorized as treatment preference for the purpose of this review. Nearly half of all published studies addressed a treatment preference (51%), with 33% of the studies focused on treatment adherence and 16% examined screening decisions.

Area of medicine The most frequently studied areas of medicine were cancer screening and treatment, risk reduction strategies, advanced care planning/advanced directives, and adherence to diabetes management recommendations. All included studies are listed in Table 2 by area of medicine and whether the videos were used alone or as part of a larger intervention. Study Type Most studies performed were quantitative (454/488, 93%), looking for a percentage change between baseline and post-intervention or between groups of participants. A much smaller number were qualitative in nature, exploring what components of an intervention were useful or in what manner participants were impacted by the DA (18/488, 4%). There were also some studies that combined both of these, reporting quantitative outcomes as well as qualitative assessments (16/488, 3%). Overall impact The reported impact of the video intervention was analyzed according to whether the video was used alone or in conjunction with another intervention and is illustrated by figure 5. Video was used as the only intervention in 44% of studies (215/488), while the remaining 60% of studies evaluated video as a part of a larger intervention. Studies reporting a positive outcome for video interventions were the most frequent, in 69% (339/488). This applied both to studies in which the video was used alone (141/488) or as a component of a larger intervention (198/488). No effect was described in 51 studies with videos used alone (10%) and in 61 studies in which videos were used as a component of the intervention (13%). A negative impact, described as patients choosing a less desirable outcome as determined by the authors of an article or failing to make a choice, was reported in 2 studies in which videos were used exclusively and in 7 studies in which videos were a component of the intervention. In 38/488 studies, the impact of the video could not be determined due to insufficient data reported in the study. These studies also include the qualitative studies in which the authors do not report effect size. Because videos were used to a varying degree across interventions, it was impossible to determine the extent to which the positive effect in studies that incorporated multiple interventions is attributable to videos. Studies by country Studies were conducted in 38 countries. Three were the result of collaborations across multiple countries. The majority of studies (67%; 273/407) were conducted in the United States, with the second highest number being performed in the UK at 34/407. Country of publication is included in Table 2. Publication trends over time Trends in reporting over time are illustrated in figure 6.

Discussion and Conclusions Discussion In general, video-based decision aids are widely and increasingly used. They appear to have either a positive effect or no impact with very few studies reporting a negative outcome when using these tools, as found in the Cochrane Review. They are primarily focused on adults within a limited number of specific medical decisions and most of the research is being conducted in the United States. In general the studies are relatively small, recruiting fewer than 200 participants. The bulk of studies focused on qualitative assessment of effectiveness with a small proportion examining the mechanisms by which DA affect patients’ decision-making process. A significant body of research has been conducted and published regarding the use of video interventions for health care decisions. Some areas are well studied, most notably oncology, but to a lesser degree internal medicine, endocrinology, obstetrics, and advance care planning and advance directives. Many areas of medicine, such as pediatrics, have few studies and are areas in which further study could be beneficial. The small number of studies that focused on children is worth highlighting, since this is a population that might be expected to desire and benefit from video-based education the most due to lower literacy and a general preference for visual media. In general, pediatric studies may be harder to conduct and complete due to the added ethical considerations when performing research on minors. The areas of study are likewise somewhat different. Further, video-based decision aids also need to consider the patients’ developmental capacity to understand the information, and take into account the family context and the role of caregivers in patients’ decisions. More study in this area should yield information that could be transformative to the provision of care in this population. The trend in the number of new publications per year indicates that this is an active area of research. As there is the potential for a great deal of overlap between studied areas of interest, knowledge of what tools have been used, particularly those that were beneficial could help shape future tool development. There is limited benefit to further small studies in well-published areas, and future studies should focus on providing novel insights rather than repeating similar studies to what are already available. Qualitative research in particular would be helpful in providing an understanding of the factors that affect the effectiveness of video-based interventions. Some decisions were difficult to characterize as positive or negative. The decision to pursue screening for prostate cancer, for example, can be either the desired outcome or the negative outcome depending on the perspective of the researcher. Some studies examined potentially decreasing health care utilization or increasing patient engagement with care, which may involve the patient choosing not to pursue a particular medical therapy. In these cases, it is imperative for researchers to clearly define the desired outcome of the intervention. The use of appropriate control groups and clearly describing the components of a multi-faceted intervention are helpful when clinicians appraise whether a particular published intervention might be applicable to their patient population. Limitations

Videos used for decision aids could be either produced to be the decision aid itself (e.g. a narrative video depicting different treatment options) or a way to deliver another DA. An example of this would be a physician videotaped reviewing a printed DA. These different types of videos may serve different purposes such as decreasing clinic time (and thereby increasing cost-effectiveness) or minimizing variability between provisions of risks by different providers. Standards for certification of a video as a patient decision aid or support intervention have been proposed but may not be universally implemented or even considered when an aid is being developed. Older research would not have been done with this in mind as it predated any proposed framework. As a result, there is a great deal of variability between what is described and used as a video decision aid. The decision aids studied were variable in their design with some intended to stand independently and others used as a component in a larger intervention that may have included in-person counselling, written materials, and group meetings. Further exploration could be done by interrogating particular subgroups of studies to determine the magnitude of success within these subgroups and if there is a common component in the interventions that were the most successful. The impact of the interventions are reported at the solely discretion of the authors and therefore difficult to compare across studies. Not all authors will have the same definition of a positive or negative outcome, and a reviewer may also not agree. For example, for some authors a reduction in prostate cancer screening was desirable, not all readers will see it the same way. An impact may be statistically significant but not clinically so, or vice versa. It is difficult to say with certainty that we were able to capture all the available literature despite our best efforts. Studies may not be indexed well and therefore not be captured by our database searches, even if they are very broad. Titles and abstracts may not have had sufficient information to trigger a full text review of an article that was relevant. Studies may be published in non-indexed journals or in the grey literature so that they are not available for review. Almost all of the studies that we reviewed were in English, so it is suspected that there is another pool of studies that is not accessed by this strategy. Finally, we reviewed the literature available until the end of 2016, but there are likely new studies that have been published since the end of this period that add to the body of knowledge already collected. Conclusion Video based patient decision aids are largely a positive addition to the traditional process of health care provision. They are used primarily to assist patients in making an informed decision about screening, to promote adherence to medical recommendations, and to help patients in making choices of treatment where more than one option exists. Practice Implications The published literature regarding the use of video-based decision aids spans many clinical contexts and decisions. The effect has largely been positive, which should encourage the ongoing development and use of videos to assist patients in clarifying their priorities, choosing treatments, or

adhering to medical therapy recommendations. Many videos used in the published studies are available for review online or by request from the authors. These may be an untapped resource for clinicians seeking a pre-made tool, or provide a basis for developing a version for their own use. Multimedia is increasingly ubiquitous in our society and the medical profession can benefit from these advances to help patients navigate complex medical decisions. Future research in this area should be guided by the extensive literature already published. Research should address areas of medical practice in which fewer studies have been completed, or analyze the components that make a particular video-based patient decision aid successful or not. This review did not specifically analyze the elements described in qualitative studies and this could be an area for further exploration in another review. Further research into the cost-effectiveness of decision aids may also help guide interactions if patients can be well served in a less resource-intensive manner. Children have not been studied as extensively as adults, but the development of effective video-based decision aids for this age group may have the most promise of benefit due to the ubiquity of multimedia to which they are exposed and use. Submission declaration and verification: This article has not been published previously and is not under consideration for publication elsewhere. It is being submitted as part of an academic thesis. If accepted, it will not be published elsewhere outside of the academic thesis. Author contributions: Karin Winston participated in the conception and design of the study, acquired and analysed the data and drafted the article. She has approved the final version for submission. Petra Grendarova participated in the conception and design of the study, acquired the data, and revised the draft for intellectual content. She has approved the final version for submission. Doreen Rabi consulted in the conception and design of the study and guided the representation of the data. She aided in revision of the final draft and has approved the final version for submission. Funding: Karin Winston was funded in part by a fellowship grant from the Canadian Pediatric Endocrine Group (CPEG). The CPEG had no role in the study design, data collection, analysis, interpretation, writing of the article, or decision to submit the article for publication. Petra Grendarova was funded in part by the Anthony Fields Clinical Fellowship grant from the Alberta Cancer Foundation. The Alberta Cancer Foundation had no role in the study design, data collection, analysis, interpretation, writing of the article, or decision to submit the article for publication. Doreen Rabi did not have any external funding relevant to this project.

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471. Goisman RM, Kent AB, Montgomery EC, Cheevers MM, Goldfinger SM. AIDS education for patients with chronic mental illness. Community Ment Health J. 1991 27(3):189-97. 472. Schuckit MA, Smith TL, Kalmijn J, Skidmore J, Clausen P, Shafir A, Saunders G, Bystritsky H, Fromme K. The impact of focusing a program to prevent heavier drinking on a pre-existing phenotype, the low level of response to alcohol. Alcohol Clin Exp Res. 2015 39(2):308-16. 473. Haines TP, Hill AM, Hill KD, McPhail S, Oliver D, Brauer S, et al. Patient education to prevent falls among older hospital inpatients: a randomized controlled trial. Arch Intern Med. 2011 171(6):516-24. 474. Wells J, Clark KD, Sarno K. A computer-based interactive multimedia program to reduce HIV transmission for women with intellectual disability. J Intellect Disabil Res 2012 56(4):371-81. 475. Hightow-Weidman LB, Pike E, Fowler B, Matthews DM, Kibe J, McCoy R, et al. HealthMpowerment.org: feasibility and acceptability of delivering an internet intervention to young Black men who have sex with men. AIDS Care. 2012 24(7):910-20. 476. Zimmerman RS, Palmgreen PM, Noar SM, Lustria MLA, Lu H, Horosewski ML. Effects of a televised two-city safer sex mass media campaign targeting high-sensation-seeking and impulsive-decisionmaking young adults. Health Educ Behav. 2007 34(5):810-26. 477. Hill A-M, Etherton-Beer C, Haines TP. Tailored Education for Older Patients to Facilitate Engagement in Falls Prevention Strategies after Hospital Discharge-A Pilot Randomized Controlled Trial. PLoS ONE. 2013 8(5):1-11. 478. Hughes BR, Altman DG, Newton JA. Melanoma and skin cancer: Evaluation of a health education programme for secondary schools. Br J Dermatol. 1993 128(4):412-7. 479. Kelly PJ, Owen SV, Peralez-Dieckmann E, Martinez E. Health Interventions With Girls in the Juvenile Justice System. Womens Health Issues. 2007 17(4):227-36. 480. Lana A, Faya-Ornia G, Lopez ML. Impact of a web-based intervention supplemented with text messages to improve cancer prevention behaviors among adolescents: results from a randomized controlled trial. Prev Med.2014 59:54-9. 481. Lindholm LH, Isacsson A, Slaug B, Moller TR. Acceptance by Swedish users of a multimedia program for primary and secondary prevention of malignant melanoma. J Cancer Educ. 1998 13(4):207-12. 482. Malow RM, West JA, Corrigan SA, Pena JM, Cunningham SC. Outcome of psychoeducation for HIV risk reduction. AIDS Educ Prev. 19946(2):113-25. 483. Noell J, Ary D, Duncan T. Development and evaluation of a sexual decision-making and social skills program: "the choice is yours--preventing HIV/STDs". Health Educ Behav. 1997 24(1):87-101. 484. Potter P, Pion S, Klinkenberg D, Kuhrik M, Kuhrik N. An instructional DVD fall-prevention program for patients with cancer and family caregivers. Oncol Nurs Forum. 2014 41(5):486-94. 485. O'Donnell L, San Doval A, Duran R, O'Donnell CR. The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients. Sex Transm Dis. 1995 (2):97-103.

486. O'Donnell LN, Doval AS, Duran R, O'Donnell C. Video-based sexually transmitted disease patient education: its impact on condom acquisition. Am J Public Health. 1995 85(6):817-22. 487. Rickert VI, Gottlieb AA, Jay MS. Is AIDS education related to condom acquisition?. Clin Pediatr (Phila). 1992 31(4):205-10. 488. Solomon MZ, DeJong W. Preventing AIDS and other STDs through condom promotion: a patient education intervention. Am J Public Health. 1989 79(4):453-8. 489. Thamboo A, Nguyen T, Ludemann JP. Choking prevention: shortcomings of traditional public education campaigns, prompting the development of web-based interactive teaching tools for preteens, teenagers, and adults. J Otolaryngol Head Neck Surg. 2009 38(6):646-51. 490. Tyc VL, Rai SN, Lensing S, Klosky JL, Stewart DB, Gattuso J. Intervention to reduce intentions to use tobacco among pediatric cancer survivors. J Clin Oncol. 2003 21(7):1366-72. 491. Yuan L, Manderson L, Tempongko MSB, Wei W, Aiguo P. The impact of educational videotapes on water contact behaviour of primary school students in the Dongting lakes region, China. Trop Med Int Health. 2000 5(8):538-44. 492. Adeola R, Omorogbe A, Johnson A. Get the Message: A Teen Distracted Driving Program. J Trauma Nurs. 2016 23(6): 312-320. 493. Kelly NR, Huffman LC, Mendoza FS, Robinson TN. Effects of a videotape to increase use of poison control centers by low-income and Spanish-speaking families: a randomized, controlled trial. Pediatrics. 2003 111(1):21-6. 494. France CR, France JL, Wissel ME, Kowalsky JM, Bolinger EM, Huckins JL. Enhancing blood donation intentions using multimedia donor education materials. Transfusion. 2011 51(8):1796-801. 495. France CR, France JL, Kowalsky JM, Copley DM, Lewis KN, Ellis GD, et al. A Web-based approach to blood donor preparation. Transfusion. 2013 53(2):328-36. 496. Brison RJ, Hartling L, Dostaler S, Leger A, Rowe BH, Stiell I, et al. A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine. 2005 30(16):1799-807. 497. Hoffman J, Salzman C, Garbaccio C, Burns SP, Crane D, Bombardier C. Use of on-demand video to provide patient education on spinal cord injury. J Spinal Cord Med. 2011 34(4):404-9. 498. Oliveira A, Gevirtz R, Hubbard D. A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries. Spine. 2006 31(15):1652-7. 499. Kelly-Blake K, Wills CE, Holmes-Rovner M, Rovner D, Lillie J, Price C, et al. Older men and sexual function: Is BPH treatment a high stakes decision?. Int J Mens Health. 2006 5(1):93-101. 500. Barry MJ, Fowler FJ,Jr, Mulley AG,Jr, Henderson JV,Jr, Wennberg JE. Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care. 1995 33(8):771-82.

501. Piercy GB, Deber R, Trachtenberg J, Ramsey EW, Norman RW, Goldenberg SL, et al. Impact of a shared decision-making program on patients with benign prostatic hyperplasia. Urology. 1999 53(5):91320. 502. Barry MJ, Cherkin DC, Chang Y, Fowler FJ, Jr, Skates S. A randomized trial of a multimedia shared decision-making program for men facing a treatment decision for benign prostatic hyperplasia. Disease Management and Clinical Outcomes. 1997 1(1):5-14. 503. Wills CE, Holmes-Rovner M, Rovner D, Lillie J, Kelly-Blake K, Bonham V, et al. Treatment preference patterns during a videotape decision aid for benign prostatic hyperplasia (BPH). Patient Educ Couns. 2006 61(1):16-22 504. Callaghan P, Cheung YL, Yao KY, Chan SL. Evidence-based care of Chinese men having transurethral resection of the prostate (TURP). J Adv Nurs. 1998 28(3):576-83.

Figure 1. Citation Flowsheet Initial Search: Medline – 16605 Embase – 9073 CinAHL – 5534 PsychInfo - 95 Pubmed – 807 Journal Hand search – 40*

Unique citations: 32154

Articles for full text review: 2396

Deduplication *Journals hand-searched included Medical Decision Making and Patient Education and Communication

Title/abstract review for relevance

Rejected articles: No video component: 665 No medical decision: 929 Not original research: 318

Additional citations from reference search: 4

Total articles for analysis: 488

Figure 2. Analysis by Sample Size 160

144

Number of Citations

140 120

107

100

70

80 60

40 20

20

13

29

16

24 27 10

7

6

7

0

Number of participants

Figure 3. Analysis by age

Distribution of participants by age 3.2%

9.5%

87.4%

Mixed

Figure 4. Analysis by sex

Pediatric

Adult

8

Distribution of participants by sex 22.5%

8.6%

68.8%

mixed

male

female

Figure 5. Effect of Video Intervention 250 198

200

141

150 100

Video Alone 51

61

50 2 7 0

21 17

Video Component

Figure 6. Publication Trend

Publication Trend over Time 50 45 40 35 30 25 20 15 10 5 0

Table 1. Scoping Review Search strategy Ovid MEDLINE Search Theme

MeSH Terms

Video

video, video recording, video-audio media, videotape recording, tape recording, television, internet, youtube, social media, mobile app, CDROM, DVD, podcast, webcasts

DecisionMaking

patient education; patient education as topic; decision making; patient participation; decision support techniques; decision support systems, clinical; decision support; decision making, computerassisted

Ovid EMBASE Text Words

Emtree Terms

Text Words

video, multimedia, audiovisual

Audiovisual aids; multimedia; video recording; video-audio media; videotape recording; internet, social media, youtube, mobile application, podcast

Video, multimedia, audiovisual

decision support system, decision aid, patient adj4 educ*

Patient education; decision making; patient participation; decision support techniques; decision support systems, clinical

Patient education, patient decision making, decision support system*, decision aid*, decision support technique*

Table 2. Summary of Included Articles Video Alone Area of Medicine

Author

Video Component

Country

Year

Addiction Adolescent Medicine Advance Care Planning

Anaesthesiology

Lohan [14]

Author

Country

Year

Gelberg [13]

USA

2015

Ireland

2011

El-Jawahri [15]

USA

2010

Beck [16]

USA

2002

Epstein [17]

USA

2013

Brown [18]

USA

1999

Epstein [19]

USA

2015

Cugliari [20]

USA

1999

Patel [21]

USA

2016

Deep [3]

USA

2010

Sheridan [22]

USA

1996

Einterz [23]

USA

2014

Toraya [24]

USA

2014

El-Jawahri [25]

USA

2015

Volandes [26]

USA

2007

El-Jawahri [27]

USA

2016

Volandes [28]

USA

2008

Hickman [29]

USA

2014

Volandes [30]

USA

2008

Ho [31]

Canada

2000

Volandes [32]

USA

2009

Matsui [33]

Japan

2010

Volandes [34]

USA

2009

Rhondali [35]

USA

2013

Volandes [36]

USA

2010

Sadeghi [37]

USA

2016

Volandes [38]

USA

2011

Siegert [39]

USA

1996

Volandes [40]

USA

2012

van Scoy [41]

USA

2016

Volandes [42]

USA

2012

Wilson [43]

USA

2015

Volandes [44]

USA

2013

Yamada [45]

USA

1999

Volandes [46]

USA

2016

Chen [47]

Taiwan

2005

Capewell [48]

Australia

1993

Hong [50]

USA

1999

Yeh [52]

Pierscinski [53]

Poland

2007

Bariatric Surgery

Arterburn [54]

USA

2011

Cardiology/Cardiac Sugery

Collins [55]

USA

2009

Boyde [56]

Liao [57]

USA

1996

Clarkesmith [58]

Mahler [59]

USA

1998

Hwang [60]

Mahler [61]

USA

1999

Smith [63]

USA

Thomas [65]

USA

Vickers [67]

USA

Hawkins [49] Knoerl [51]

UK

2010

South Korea

2012

Taiwan

2007

Australia

2013

UK

2013

South Korea

2015

Liou [62]

Taiwan

2015

2005

Morgan [64]

Canada

2000

2011

Pack [66]

USA

2013

2011

Stromberg [68]

Sweden

2006

USA

2012

South Korea

2014

Taiwan

2010

Veroff [69] (pediatric) Dentistry (pediatric) Dermatology

(pediatric)

Uzark [70]

USA

1982

Gatchel [71]

USA

1986

Kupietzky [73]

Israel

2006

Agbai [74]

USA

2016

Lo [75]

Love [76]

USA

2016

Neibel [77]

Germany

2000

Janda [78]

Australia

2014

Roman [79]

USA

2016

Tuong [80]

USA

2015

Mun [72]

Emergency Medicine Endocrinology

Blank [81]

USA

1998

Blank [82]

USA

2002

Dyson [83]

UK

2010

Bell [84]

USA

2012

Gerber [85]

USA

2005

Bradshaw [86]

UK

1999

Grady [87]

USA

2011

Brown [88]

USA

1995

Streuli [4]

Switzerland

2013

Elshaw [89]

USA

1994

Glasgow [90]

USA

1995

Glasgow [91]

USA

1997

Glasgow [92]

USA

2009

Glasgow [93]

USA

2011

Sweden

2013

USA

2014

Hernandez [96]

Canada

2004

Huang [97]

Taiwan

2009

Mulrow [98]

UK

1987

Sieber [99]

USA

2012

Tan [100]

Singapore

1997

Hanberger [94] Heisler [95]

Tang [101]

USA

2013

Norway

2008

USA

2005

Wu [104]

Taiwan

2014

Nordfeldt [105]

Sweden

2003

Nordfeldt [106]

Sweden

2005

Pichert [107]

USA

1994

UK

2016

Taiwan

2015

Wangberg [102] Williams [103] (pediatric)

ENT

Krouse [108]

USA

2001

Ferguson [109]

Gastroenterology

Clayton [110]

USA

2016

Chang [111]

Hayat [112]

USA

2016

Hsueh [113]

Taiwan

2014

Garg [114]

USA

2016

Padilla [115]

USA

1981

Hsu [116]

Taiwan

2015

Park [117]

South Korea

2016

Prakash [118]

USA

2013

Barry [119]

USA

1984

Arciti [120]

Italy

1995

Bokhour [121]

USA

2016

Beaudoin [122]

Canada

2014

Comite [123]

USA

1998

Bessette [124]

Canada

2011

Davis [125]

UK

2012

Burkett [126]

USA

2010

Canada

2013

Byrd [128]

USA

1993

Garcia-Williams 0129]

USA

2010

Carey [130]

Gates [131]

USA

2005

Cho [132]

Goodman [133]

USA

2011

Canada

Houston [137] Kulp [139]

General Medicine

de Jesus [127]

Australia

1992

South Korea

2012

Cooper [134]

USA

2009

2010

Danaher [136]

Canada/USA

2008

USA

2011

Doubova [138]

Mexico

2010

USA

2004

Eckman [140]

USA

2012

Powell [141]

USA

1995

Emmett [142]

UK

2005

Shepperd [143]

UK

1995

Feldman [144]

Canada

2012

Gross [135]

Gerber [145]

USA

2013

Glasgow [146]

USA

2000

Greene [147]

USA

1992

Horrey [148]

USA

2009

Jenkins [149]

USA

1997

Indonesia

2006

USA

2008

Taiwan

2011

USA Spain

2000 1990

Montgomery [155]

UK

2003

North [156]

USA

2011

Patten [157]

USA

2011

Prokhorov [158]

USA

2008

Resnicow [159]

USA

1997

Simmons [160]

USA

2013

Smith [161]

USA

2003

Stevens [162]

USA

1993

Kim [150] Lichtenstein [151] Lo [152] Manfredi [153] Martinez-Amenos 154]

Stosny [163] Vormfelde [164] Wing [165]

Genetics/Obstetrics

Geriatrics

Obstetrics/Gynecology

USA

1994

Germany

2014

USA

2010

Bjorklund [166]

Sweden

2012

Beulen [167]

Netherlands

2016

Hewison [168]

UK

2011

Leung [169]

Hong Kong

2004

Kleijer [170]

UK

2001

Michie [171]

UK

1997

Muller [172]

New Zealand

2014

Taber [173]

USA

2015

Sanderson [174]

USA

2016

Caro [175]

USA

2012

Clark [176]

USA

2000

Foldi [177]

USA

2005

Frosch [178]

USA

2010

USA USA

2013 1995

Nigeria

1997

Buck [180]

USA

2015

Snyder [179] Beckmann [181]

Davidson [182]

USA

2015

Bello Gummi [183]

Goodman [184] Hans [186]

USA USA

2015 2011

Caulfield [185]

USA

1998

Gilliam [187]

USA

2004

Australia

2010

Gross [189]

USA

1998

Kellams [190] Kinzie [192]

USA USA

2016 1993

Huang [191]

Taiwan

2007

Jackson [193]

USA

2011

Labarere [194]

France

2011

Kennedy [195]

UK

2002

Moran [196]

USA

2016

Kim [197]

Korea

1998

Ohman [198]

Sweden

2012

Lin [199]

Taiwan

2008

USA

1989

Murray [201]

UK

2001

Zambia

2011

Mynaugh [203]

USA

1991

Ondersma [204]

USA

2015

Hope [188]

Reis [200] Stephenson [202]

Hematology

Infectious Disease

Renker [206]

USA

2007

Rosen [207]

USA

2008

Sharma [208

Nepal

2007

Solberg [209]

USA

2010

Tsoh [210]

USA

2010

Walsh-Buhi [211]

USA

2016

Windsor [212]

USA

2000

Windsor [213]

USA

2011

Gallo [214]

USA

2016

LaVista [215]

USA

2009

Wilkie [216]

USA

2013

2003

Crawford [218]

USA

2016

Aronson [219]

USA

2011

Goodman [220]

USA

1994

Aronson [221]

USA

2014

Hemo [222]

Israel

2009

USA

2015

Hoppe [224]

USA

2011

Bishai [225]

France/Germany

2007

Ingersoll [226]

USA

2011

Brock [227]

USA

2007

Marinho [228]

Portugal

2016

Burns [229]

UK

2013

Sampaio-Sa [230]

Brasil

2008

Calderon [231]

USA

2007

Solomon [232]

USA

1988

Calderon [233]

USA

2009

Thomas [234]

USA

2003

Carey [235]

USA

2008

Chapman [236]

USA

2010

Eubelen [237]

Belgium

2011

USA

2016

Krawczyk [239]

Canada

2012

Mhalu [240]

Tanzania

2015

Maneesriwongul [241]

USA

2013

Thailand

2012

Solomon [242]

USA

1988

Trent [243]

USA

2010

Triese [244]

USA

2016

Thailand

2015

Yusufari [246]

Nigeria

2011

van Zyl [247]

South Africa

2014

van Zyl [248]

South Africa

2014

Baraz [249]

Iran

2010

Boulware [250]

Lawson [251]

USA

1976

Castledine [252]

UK

2013

Mooney [253]

UK

2009

Giacoma [254]

USA

1999

Winterbottom [255]

UK

2012

Goovaerts [256]

Belgium

2005

Manns [257]

Canada

2005

Pradel [258]

USA

2008

Shaw-Stuart 259]

USA

2000

Pascual [261]

USA

2015

Worasathit [245]

Neurology

2005

USA

Frew [238]

Nephrology

Zimbabwe

Apanovitch [217]

Aronson [223]

(pediatric)

Piwoz [205]

Hodgson [260]

Canada

2009

Oncology

Yvonne Chan [263]

USA

2010

2004

Aragones [266]

USA

2010

Hsieh [262]

Taiwan

2014

Silver [264]

USA

2012

Avis [265]

USA

Brenner [267]

USA

2016

Berry [268]

USA

2012

Bytzer [269]

Denmark

2007

Berry [270]

USA

2013

Flood [271]

USA

1996

Byrd [272]

USA

2013

Friedman [273]

USA

2011

Cameron [274]

USA

2011

Frosch [275]

USA

2003

Champion [276]

USA

2006

Frosch [277]

USA

2008

Chan [278]

China

2004

Australia

2005

Chan [280]

USA

2011

Gimeno-Garcia [281]

Spain

2006

Chapman [282]

USA

1995

Goel [283]

USA

2010

Clotfelter [284]

USA

1999

Griffith [285]

USA

2008

Collinge [286]

USA

2012

Janda [287]

Australia

2002

Davis [288]

USA

1998

Katz [289]

USA

2009

Davis [290]

USA

2013

Kinnane [291]

Australia

2008

Deavenport [292]

USA

2011

Kreuter [293]

USA

2010

Dravet [294]

France

2010

Lewis [295]

USA

2015

Evans [296]

UK

2010

Meropol [297]

USA

2016

Fee-Schroeder [298]

USA

2013

Partin [299]

USA

2004

Frosch [300]

USA

2001

Perez [301]

USA

2014

Jibaja-Weiss [302]

USA

2011

Powe [303]

USA

1999

Kassan [304]

USA

2012

Reuland [305]

USA

2012

Katz [306]

USA

2011

Ruthman [307]

USA

2004

Kim [308]

USA

2001

Sanderson [309]

USA

2010

Laszewski [310]

USA

2016

Schapira [311]

USA

1997

Lo [312]

Taiwan

2011

Sheehan [313]

USA

2009

Loescher [314]

USA

2013

Valdez [315]

USA

2002

Love [316]

USA

2009

Volk [317]

USA

2003

Lovell [318]

Australia

2010

Walker [319]

USA

2005

Manne [320]

USA

2015

Wang [321]

USA

2008

Marcus [322]

USA

2010

Wang [323]

USA

2012

Maslin [324]

UK

1998

Wilkins [325]

USA

2008

Maxwell [326]

USA

2011

Zapka [327]

USA

2004

Miller [328]

USA

2005

Miller [329]

USA

2011

Gattellari [279]

Mock [330]

USA

2007

Molenaar [331]

Netherlands

2001

Morrison [332]

USA

2012

Mostert [333]

Indonesia

2010

Nguyen [334]

USA

2006

Pignone [335]

USA

2000

Rosenzweig [336]

USA

2011

Ruffin [337]

USA

2007

Russell [338]

USA

2007

Sandiford [339]

USA

2016

Sepucha [340]

USA

2009

Shaffer [341]

USA

2013

Sherman [342]

USA

2016

Sivell [343]

UK

2012

Street [344]

USA

1995

Syrjala [345]

USA

2008

Taylor [346]

USA

1999

Taylor [347]

Canada/USA

2002

Taylor [348]

USA

2006

Taylor [349]

USA

2013

Tu [350]

USA

2001

Valdez [351]

USA

2006

van Roosmalen [352]

Ophthalmology

Netherlands

2004

Volk [353]

USA

1999

UK

1997

China

2012

USA

2007

Claydon [355]

Hua [356]

China

2014

Liu [357]

Muir [358]

USA

2012

Okeke [359]

USA

2009

Pradeep [360]

UK

2014

Goldstein [354]

(pediatric) Organ Donation

Rodrigue [361]

USA

2014

Fahrenwald [362]

USA

2010

Orthopedic Surgery

Thornton [363] Barrett [364]

USA USA

2012 2002

Bozic [365]

USA

2013

Doering [366]

Austria

2001

Deyo [367]

USA

2000

Lurie [368]

USA

2011

Goldberg [369]

USA

2001

Tappen [370]

USA

2003

Kearing [371]

USA

2016

Lewis [372]

USA

2002

Phelan [373]

USA

2001

Shue [374]

USA

2016

Spunt [375]

USA

1996

Vina [376]

USA

2016

Weng [377]

USA

2007

Wong [378]

Canada

1990

Yeh [379]

Taiwan

2005

(pediatric) Pediatrics

LaMontagne [380]

USA

2004

Atlantis [381]

Australia

2008

Bauchner [382]

USA

2001

Bannon [383]

USA

2006

Botkin [384]

USA

2016

Erkoboni [385]

China

2010

Chang [386]

USA

1989

USA

1999

Chen [388]

China

2014

Fujiwara [389]

Japan

2012

Evans [390]

UK

2009

Halford [391]

UK

2007

Hanks [392]

USA

2016

Halford [393]

UK

2008

Hollen [394]

USA

2013

Hempel [395]

USA

1992

Lewis [396]

USA

1991

Enzenauer [387]

Morrongiello [397]

Canada

2013

Redsell [398]

UK

2002

Paradis [399]

USA

2011

Taddio [400]

Canada

2015

Tietge [401]

USA

1987

Wade [402]

USA

2009

Windham [403]

USA

2014

Wendland-Carro [404]

Brazil

1999

Bassett [405]

New Zealand

2011

Roddey [406]

USA

2002

Miller [407]

UK

2007

Plastic Surgery

Boudreault [408]

USA

2016

Psychiatry

Barker [410]

UK

1993

So [409] Bosmans [411]

Canada Netherlands

2003 2007

Hagan [412]

USA

1983

Brook [413]

Netherlands

2005

Kravitz [414]

USA

2013

Deitz [415]

USA

2011

Lash [416]

USA

1998

Doiron [417]

Canada

2007

Pieroni [418]

UK

2010

Winzelberg [419]

USA

1998

Pruitt [420]

USA

2012

Radiology

Mattingly [421]

USA

2011

Research

Banda [422]

USA

2012

Fureman [423]

USA

1997

Du [424]

USA

2008

Schoenfeld [425]

USA

2000

Du [426]

USA

2009

Umutyan [427]

USA

2008

Dunlop [428]

USA

2011

Wallace [429]

Canada

2006

Hazen [430]

USA

2010

Wells [431]

USA

2013

Hutchison [432]

UK

2007

Wragg [433]

UK

2000

Japan

2007

Krieger [435]

USA

2011

Tehranisa [436]

USA

2014

Weston [437]

Canada

1997

Basoglu [438]

Turkey

2012

Chen [439]

Taiwan

2010

Fries [440]

USA

2005

Choy [441]

China

2012

Jean Wiese [442]

USA

2005

Cordina [443]

Malta

2001

Petty [444]

USA

2006

Goris [445]

Turkey

2013

Australia

1998

Physical Therapy

Ishii [434]

Respirology

Holzheimer [446] Hui [447]

China

2000

Krishna [448]

USA

2003

Krishna [449]

USA

2006

Lai [450]

China

2014

Liu [451]

Australia

2001

UK

2009

Canada

2016

Rhee [454]

USA

2008

Taggart [455]

USA

1991

Zorc [456]

USA

2009

Moore [452] Trenaman [453] (pediatric)

Rheumatology Risk Reduction

Warriner [457] Armstrong [458]

USA USA

2015 2011

Artz [459]

USA

2005

Besera [460]

USA

2016

Brunette [461]

USA

2015

Calderon [462]

USA

2013

Bull [463]

USA

2009

Greenwood [464]

USA

2014

Gilbert [465]

USA

2008

Lee [466]

South Korea

2016

Gillespie [467]

Australia

2014

O'Donnell [468]

USA

1998

Glasser [469]

USA

2010

Potter [470]

USA

2012

Goisman [471]

USA

1991

Schuckit [472]

USA

2015

Haines [473]

Australia

2011

Wells [474]

USA

2011

Hightow-Weidman [475]

Zimmerman [476]

USA

2007

Hill [477]

USA

2012

Australia

2013

UK

1993

USA Spain, Mexico Sweden

2007

Malow [482]

USA

1994

Noell [483]

USA

1997

Potter [484]

USA

2014

O'Donnell [485]

USA

1995

O'Donnell [486]

USA

1995

Rickert [487]

USA

1992

Solomon [488]

USA

1989

Thamboo [489]

Canada

2009

USA

2003

China

2000

France [494]

USA

2011

France [495]

USA

2013

Hoffman [497]

USA

2011

Hughes [478] Kelly [479] Lana [480] Lindholm [481]

Tyc [490] Yuan [491] (pediatric) Toxicology

Adeola [492]

USA

2016

Kelly [493]

USA

2003

Transfusion Medicine Trauma Urology

2014 1998

Brison [496]

Canada

2005

Oliveira 498]

USA

2006

Kelly-Blake [499]

USA

2006

Barry [500]

USA

1995

Piercy [501]

Canada

1999

Barry [502]

USA

1997

Wills [503]

USA

2006

Callaghan [504]

China

1998