Decision Support Tools in Deceased Donor Kidney Transplantation: An Environmental Scan and Appraisal of Online Resources

The pathway to deceased donor kidney transplantation involves complex risk assessment and decision-making by donor coordinators, transplant clinicians, and patients. We reviewed freely available tools designed to facilitate decision-making in the context of deceased donor kidney transplantation for usability and communication efficacy. An environmental scan was conducted using Google; search results meeting inclusion criteria were appraised by 3 independent reviewers using the International Patient Decision Aids Standards Instrument, the Patient Education Material Evaluation Tool, and the Healthcare Systems Usability Scale. In total, 3885 search results were reviewed, from which 6 patient-directed decision aids, 1 clinician-directed decision aid, and 10 risk calculators were identified. Of the 6 patient-directed decision aids, 3 met International Patient Decision Aids Standards Instrument qualification criteria; none met certification criteria. Four of 6 decision aids were understandable by Patient Education Material Evaluation Tool criteria, whereas only 1 was actionable. Mean Healthcare Systems Usability Scale scores for the 10 risk calculators identified ranged from 50% (indicating major usability concerns) to 86% (indicating good usability with potential for improvements), with a median score of 71%. More high-quality decision support tools are needed for use in deceased donor kidney transplantation, given the complexity of decisions involved, the recognized importance of effective knowledge transfer, the value of individualized prognostic information, and the benefits of structured approaches to shared decision-making in this context.