Connecting Patient Preparation to Clinical Dialogue in Digital Shared Decision-Making: A Focused Rapid Review of Reviews With a Mechanism-Informed Synthesis

Abstract Background Digital tools can prepare patients for decisions, but effects on clinical dialogue are uncertain. We synthesized review-level evidence on shared decision-making and examined the role of timing and workflow. Methods We rapidly reviewed systematic, meta-analytic, and scoping reviews identified through targeted PubMed, publisher-platform, and citation searches to 17 July 2026. One reviewer selected, extracted, and appraised reports and revisited eligibility after extraction. We synthesized outcomes descriptively and developed an interpretive model. Results Eleven reviews were included. Knowledge, decisional conflict, and preparation generally improved; evidence for interpersonal processes was less extensive. Preconsultation aids increased reported decision discussion (68.6% versus 50.2%), whereas separate in-consultation trials, mostly of paper aids, improved observer ratings (mean difference 12.14; 95% confidence interval 8.12–16.16). The trial sets were not directly compared. The five proposed links were decision recognition, patient preparation, clinical visibility, deliberative interaction, and decision closure and follow-through; downstream safety evidence was sparse. Conclusion Digital preparation alone does not establish improved deliberation or safety. The model is interpretive and unvalidated. Comparative studies should test information flow and outcomes for dialogue, quality, safety, and equity.