Stated Boasting Over ABT-888

Study and evidence quality appraisal Both reviewers will independently assess the methodological quality of included studies using the Cochrane Effective Practice and Organisation of Care Group's (EPOC) criteria for randomised, non-randomised studies, before-and-after, interrupted-time-series studies or repeated measures studies40 and the Newcastle-Ottawa Scale for observational studies.41 Using EPOC criteria, we will apply a judgment of ��unclear risk��, ��low risk�� or ��high risk�� to nine categories for each randomised, non-randomised and before-and-after study, and for seven categories for each interrupted-time-series and repeated measures study.40 Using the Newcastle-Ottawa Scale, we will award each study a maximum of nine points for items related to selection, comparability and outcome assessment bias.41 Both reviewers will also independently apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to rate the quality of evidence (high, moderate, low, very low) across studies for the primary outcome, decisional quality, using GRADEprofiler software (see online supplementary appendix 3).42 We will assess key factors that can downgrade the quality of evidence (eg, methodological quality, directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias) and upgrade the quality of evidence (ie, magnitude of effect, dose�Cresponse gradient and ability of the study to limit bias and control for confounding).43 The quality of evidence can be downgraded or upgraded by one level or two levels to eventually describe a ��high��, ��moderate��, ��low�� or ��very low�� assessment of our confidence in the estimate of effect. The methodological and evidence quality assessments made by the reviewers will be compared and disagreements resolved by discussion. PDE4B decision aid quality appraisal Both reviewers will independently assess the quality of decision aids evaluated in included studies using the International Patient Decision Aid Standards (IPDAS) checklist. This tool has 59 items which evaluate the domains of content, development process and effectiveness for decision aids not involving tests.44 For each decision aid, we will assess each checklist item as ��yes�� or ��no�� or ��not applicable��, with the final score ranging from 0 to 50 (Internet-based decision aids and those which integrate narratives have 6 and 3 additional items, respectively). Discrepant classifications will be resolved by discussion. In addition, the primary reviewer will assess the readability and reading ease of text-based decision aids using the Flesch-Kincaid test.45 46 The Flesch-Kincaid Grade Level measures textual difficulty based on words per sentence and syllables per word, and presents a score as a US grade level.