Decision aids for thrombolytic therapy in acute ischemic stroke: a scoping review

Objective This scoping review aims to summarize existing decision aids (DAs) for thrombolytic therapy in patients with acute ischemic stroke (AIS) and/or their surrogate decision-makers, explore their formats and effects, and provide implications for future tool development. Methods Systematic literature searches were conducted in PubMed, Cochrane Library, Embase, Web of Science, CNKI and SinoMed using combined subject terms and free words. Studies focusing on the development of DAs for thrombolytic therapy in patients with AIS and/or their surrogate decision-makers were included. The retrieval period spanned from database establishment to March 15, 2026. Results A total of 9 DAs were identified and classified into standardized DAs and personalized DAs, covering animated video-based aids, visual aids, conversation guide manual and computer-based programs. Evaluation based on the International Patient Decision Aid Standards (IPDASi) indicated that only a few DAs partially met the certification criteria. Most of them focus on the delivery of risk–benefit information, with deficiencies in value clarification, psychological support and long-term outcome follow-up. Conclusion 9 DAs for AIS thrombolysis were identified, comprising standardized DAs and personalized DAs. Most focus on information delivery, with insufficient attention to value clarification, psychological support, and long-term outcome assessment. Their independent efficacy remains unverified, as existing evidence derives mainly from single-center pre-post studies confounded by concurrent workflow changes. Future DAs should shift from information provision toward decision empowerment, with multicenter randomized controlled trials warranted to confirm clinical effectiveness.