Purpose: To determine whether an interactive decision dashboard, compared with a non-interactive balance sheet, increased patients' confidence in choosing between three drug treatments.
Methods: Participants were asked to imagine being diagnosed with a chronic illness that impedes daily activities and to choose between three hypothetical treatments with varying tradeoffs between effectiveness, side effects, and out-of-pocket costs. Patients indicated their treatment preferences twice: once after being shown a balance sheet (Figure 1-left) and once after an interactive dashboard (Figure 1-right). The dashboard presented drug attributes using separate graphic displays, and balanced sheet combined all in a single non-interactive table. Outcomes included preferred treatment option and change in confidence of decision after the dashboard (1-10 scale ranging from unsure to very sure). Overall evaluation of both decision aids was measured using preparation for decision making scale (0-100 scale ranging from not prepared to very prepared for decision making), acceptability of decision (how helpful and how clear was the information in the decision aid) and decisional conflict scale (0-100 scale ranging from no decision conflict to extremely high decision conflict). T-tests and paired t-tests were used to compare mean evaluation scores.
Results: Response rate was 31.5%. The average age of the volunteers was 50. Majority was female, non-Hispanic, white, highly educated, and had good numeracy skills. Mean time spent interacting with both decision aids was 16 minutes. 52 patients out of the 88 who finished the study chose treatment A, and 9 people changed their choice after using the dashboard. The mean confidence scores increased significantly after using the dashboard compared with the balance sheet (mean difference 0.67, p<0.0025). Individuals who increased in confidence were significantly more prepared to communicate with a practitioner and make a treatment choice (mean increase 12.30, p<0.0210) and had less conflict about their decision (mean difference -6.75, p<0.0420). Majority of the participants reported that information in both decision aids was clear (98.7%) and was helpful (87.5%).
Conclusion: The addition of an interactive computerized decision dashboard with visual displays of treatment attributes has potential to increase patients' confidence in their treatment choices. Patients with increased confidence were more prepared to make decision and less conflicted about their decision. 
Figure 1 – Balance sheet and Dashboard
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