BACKGROUND Low-value care initiatives are rapidly growing; however, it is not clear how members of the public should be involved. The objective of this scoping review was to systematically examine the literature describing public involvement in initatives to reduce low-value care. METHODS Evidence sources included MEDLINE, EMBASE, and CINAHL databases from inception to November 26, 2019, grey literature (CADTH Tool), reference lists of included articles, and expert consultation. Citations were screened in duplicate and included if they referred to the public's perception and/or involvement in reducing low-value care. Public included patients or citizens without any advanced healthcare knowledge. Low-value care included medical tests or treatments that lack efficacy, have risks that exceed benefit, or are not cost-effective. Extracted data pertained to study characteristics, low-value practice, clinical setting, and level of public involvement (i.e., patient-clinician interaction, research, or policy-making). RESULTS The 218 included citations were predominantly original research (n = 138, 63%), published since 2010 (n = 192, 88%), originating from North America (n = 146, 67%). Most citations focused on patient engagement within the patient-clinician interaction (n = 156, 72%), using tools that included shared decision-making (n = 66, 42%) and patient-targeted educational materials (n = 72, 46%), and reported both reductions in low-value care and improved patient perceptions regarding low-value care. Fewer citations examined public involvement in low-value care policy-making (n = 33, 15%). Among citations that examined perspectives regarding public involvement in initiatives to reduce low-value care (n = 10, 5%), there was consistent support for the utility of tools applied within the patient-clinician interaction and less consistent support for involvement in policy-making. CONCLUSIONS Efforts examining public involvement in low-value care concentrate within the patient-clinician interaction, wherein patient-oriented educational materials and shared decision-making tools have been commonly studied and are associated with reductions in low-value care. This contrasts with inclusion of the public in low-value care policy decisions wherein tools to promote engagement are less well-developed and involvement not consistently viewed as valuable. TRIAL REGISTRATION Open Science Framework (https://osf.io/6fsxm).

中文翻译：

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了解公众在减少低价医疗方面的作用：范围界定审查。

背景技术低价护理计划正在迅速增长。但是，尚不清楚公众应该如何参与。范围界定审查的目的是系统地研究描述公众参与减少低价护理的倡议的文献。方法证据来源包括从成立到2019年11月26日的MEDLINE，EMBASE和CINAHL数据库，灰色文献（CADTH Tool），包括的文章参考列表和专家咨询。引文一式两份地进行筛选，如果引用公众对减少低价医疗的看法和/或参与，则包括在内。公众包括没有任何高级医疗知识的患者或公民。低价值护理包括缺乏功效，风险超过收益或不具有成本效益的医学检验或治疗。提取的数据涉及研究特征，低价值实践，临床环境和公众参与程度（即患者与临床医生的互动，研究或政策制定）。结果218篇被引文献主要是原创研究（n = 138，63％），该研究自2010年以来发表（n = 192，88％），源自北美（n = 146，67％）。大多数引用都集中在患者与临床医生互动中的患者参与度（n = 156，72％）上，使用了包括共同决策（n = 66，42％）和针对患者的教学材料（n = 72，46％）的工具。 ），并报告了低价值医疗的减少和患者对低价值医疗的看法的改善。引用较少的文献检查了公众对低价值医疗政策制定的参与（n = 33，15％）。在引用有关公众参与减少低价医疗措施的观点的引文中（n = 10，5％），在患者与临床医生互动中使用工具的效用得到了一致的支持，而对政策干预的参与却没有得到一致的支持。制造。结论检查公众参与低价值护理的工作集中在患者与临床医生的互动中，其中以患者为导向的教材和共享的决策工具已得到广泛研究，并与低价值护理的减少相关。这与将公众包括在低价值护理政策决策中形成了鲜明对比，在这些决策中，促进参与的工具开发得不够完善，而参与也不总是被认为具有价值。试用注册开放式科学框架（https://osf.io/6fsxm）。