# Shared Decision Making, Decision Aids and Patient Reported Outcome Measures for Overactive Bladder Care: A Review

## TL;DR

This review explores how shared decision making, decision aids, and patient-reported outcomes can improve care for overactive bladder, highlighting gaps and emerging AI tools.

## Contribution

The paper reviews the current state of decision aids and patient-reported outcomes for overactive bladder and identifies limitations and emerging AI applications.

## Key findings

- Physician recommendations strongly influence patient decisions, but may not align with patient preferences.
- Few peer-reviewed decision aids for overactive bladder are publicly available.
- Artificial intelligence tools show promise for shared decision making but need validation for clinical use.

## Abstract

Shared decision making (SDM) is integral to clinical decision making for OAB. SDM is a collaborative process that takes patients’ values, preferences, and goals into account when deciding on their treatment options. Decision aids (DAs) can support SDM and patient-reported outcomes (PROs) help to assess the outcomes most important to the patient.

Twenty-five articles were retrieved and reviewed. Our search for literature about SDM in OAB found that physician recommendation is a key decisional component for patients yet that physicians’ priorities may differ widely from patients’ preferences. We evaluated currently available decision aids for OAB and found that none of the peer reviewed aids are publicly available, though non-peer reviewed, paper-based decision aids are available online. At least 10 PROs are available for OAB, these are regularly used in trials of efficacy and are increasingly being implemented in clinical practice. Finally, artificial intelligence applications such as large language models and machine learning based clinical risk prediction tools are emerging as a new facet to augment SDM, but there are limitations on the quality and the clinical implementation of these tools.

Decision aids and patient reported outcome measures are integral to the delivery of patient-centered, individualized, shared decision making for OAB. Despite this, few freely available DAs exist and many PROs are available, which makes comparison of outcomes between treatments challenging. Emerging AI technologies may further augment the SDM however require validation prior to clinical use.