Decisions about life-sustaining treatment and end-of-life care in emergency departments and intensive care units are among the most ethically complex and emotionally demanding clinical decisions. These settings commonly involve prognostic uncertainty, constrained time for deliberation and situations where patients lack decision-making capacity, necessitating involvement of family members or surrogate decision-makers. To better align care with patient values and preferences, shared decision-making (SDM) has been increasingly recommended.
Decision aids are evidence-based tools created to support informed, values-congruent decisions by presenting available options, potential benefits and harms, and prompting values clarification. While decision aids have been studied extensively in chronic disease and other preference-sensitive contexts, their application for life-sustaining treatment and end-of-life choices in acute care environments appears fragmented. The literature on such interventions in emergency and intensive care settings has not been comprehensively mapped, motivating the current scoping review protocol.
The primary aim of this scoping review is to identify and map existing literature on decision aids and related interventions that support SDM for decisions about life-sustaining treatment and end-of-life care in emergency and intensive care settings. The review focuses on tools and interventions targeting adult patients, family members, surrogate decision-makers and healthcare professionals who engage in decision-making around life-sustaining and end-of-life care in these acute environments.
Eligible records include studies published in English or Japanese from January 2000 onward. The review will include a broad range of study designs: quantitative, qualitative, mixed-methods and descriptive studies. Included interventions are decision aids or related tools explicitly designed to support shared decision-making regarding life-sustaining treatment and end-of-life care. The population of interest covers adult patients, family members, surrogate decision-makers and healthcare professionals operating in emergency or intensive care settings. Details beyond these inclusion criteria were not reported in the source.
Electronic searches will be performed in multiple bibliographic databases. The named databases are PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and Ichushi-Web. Studies must be published in English or Japanese and dated January 2000 or later to meet the eligibility window. Specific search terms, strategies, or search strings were not reported in the source document.
Two reviewers will independently conduct study screening, eligibility assessment and study selection. The protocol states that data charting will also be performed by two reviewers independently. Any further details about dispute resolution, use of a third reviewer, or screening software and tools were not reported in the source.
Data from included studies will be charted according to the scoping review protocol. The review will extract information relevant to decision aids and related interventions that support SDM for life-sustaining treatment and end-of-life care in emergency and intensive care settings. Specific data items to be charted (for example, intervention components, outcome measures, theoretical frameworks or implementation context) were not listed in the provided source material.
Findings from the scoping review will be synthesised descriptively and presented in both narrative and tabular formats. The review follows the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. No quantitative meta-analysis is planned; the presentation will focus on mapping the scope, characteristics and gaps in the literature. Specific plans for subgrouping, thematic frameworks or visualization approaches were not reported in the source.
Because the review analyses data from publicly available literature and does not involve human participants, ethics approval is not required. The authors plan to disseminate the results through publication in a peer-reviewed journal and presentation at relevant scientific conferences. The source did not provide additional details about anticipated limitations, timelines, funding, or stakeholder involvement beyond what is summarized here.