Letters

Use of interactive multimedia decision aids

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7332.296b (Published 02 February 2002) Cite this as: BMJ 2002;324:296

Alternative explanation for results may exist

  1. Trisha Greenhalgh, professor of primary health care (p.greenhalgh@pcps.ucl.ac.uk)
  1. University College London, London N19 3UA
  2. Cardiff University, Cardiff CF10 3YG
  3. Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, London N19 3UA
  4. Health Economics Research Centre, University of Oxford, Oxford OX3 7LF
  5. Picker Institute Europe, Oxford OX1 1RX

    EDITOR—The results of Murray et al's two studies on interactive multimedia decision aids are compatible with the conclusions that both they 1 2 and the author of the accompanying editorial3 draw: that such products are generally acceptable; that they lead to a substantial decrease in patients' decisional conflict; that the interactive nature of the software allows information to be personalised; that high technology decision aids, though expensive now, are likely to cost less per case in the future; that it does not much matter that the technology was obsolete and the evidence had moved on by the time the papers were published; and that such technologies should be introduced more widely.

    However, the results are also compatible with the opposite conclusion: that most patients prefer not to use (or even try out) multimedia decision support aids (hence the disappointingly low recruitment); that the absolute difference made to decisional conflict and to the actual decision made was small; that the interactivity provided only limited personalisation of the information for variables such as age and could not mirror the complexity of real life decision making; that the apparent acceptability and usefulness of multimedia decision aids might be explained by the Hawthorne effect of new technologies in educational contexts; and that the favourable economic evaluations presented failed to take into account the massive cost and lengthy time course of developing the …

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