TY - JOUR
T1 - The Influence of Decision Aids on Prostate Cancer Screening Preferences
T2 - A Randomized Survey Study
AU - Weiner, Adam B.
AU - Tsai, Kyle P.
AU - Keeter, Mary Kate
AU - Victorson, David E.
AU - Schaeffer, Edward M.
AU - Catalona, William J.
AU - Kundu, Shilajit D.
N1 - Funding Information:
Supported by NIH/NCI P50 CA 090386 and the Urological Research Foundation (WJC), and NIH 5U01CA196390 and the Prostate Cancer Foundation (EMS).
Publisher Copyright:
© 2018 American Urological Association Education and Research, Inc.
PY - 2018/11
Y1 - 2018/11
N2 - Purpose: Shared decision making is recommended in regard to prostate cancer screening. Decision aids may facilitate this process but the impact of decision aids on screening preferences is poorly understood. Materials and Methods: In an online survey we randomized a national sample of adults to the online decision aids of 1 of 6 professional societies. We compared survey responses before and after decision aid exposure. The primary outcome was the change in participant likelihood of undergoing or recommending prostate cancer screening on a scale of 1—unlikely to 100—extremely likely. Secondary outcomes included change in participant comfort with prostate cancer screening based on the average of 6, 5-point Likert-scale questions. Results: Median age was 53 years in the 1,336 participants and 50% were men. The randomized groups did not differ significantly by race, age, gender, income, marital status or education level. The likelihood of undergoing or recommending prostate cancer screening decreased from 83 to 78 following decision aid exposure (p <0.001). Reviewing the decision aid from the Centers for Disease Control or the American Academy of Family Physicians did not alter the likelihood (each p >0.2). However, the decision aid from the United States Preventive Services Task Force was associated with the largest decrease in screening preference (–16.0, p <0.001). Participants reported increased comfort (from 3.5 to 4.1 of 5) with the decision making process of prostate cancer screening following exposure to a decision aid (p <0.001). Conclusions: Exposure to a decision aid decreased the participant likelihood of undergoing or recommending prostate cancer screening and increased comfort with the screening process.
AB - Purpose: Shared decision making is recommended in regard to prostate cancer screening. Decision aids may facilitate this process but the impact of decision aids on screening preferences is poorly understood. Materials and Methods: In an online survey we randomized a national sample of adults to the online decision aids of 1 of 6 professional societies. We compared survey responses before and after decision aid exposure. The primary outcome was the change in participant likelihood of undergoing or recommending prostate cancer screening on a scale of 1—unlikely to 100—extremely likely. Secondary outcomes included change in participant comfort with prostate cancer screening based on the average of 6, 5-point Likert-scale questions. Results: Median age was 53 years in the 1,336 participants and 50% were men. The randomized groups did not differ significantly by race, age, gender, income, marital status or education level. The likelihood of undergoing or recommending prostate cancer screening decreased from 83 to 78 following decision aid exposure (p <0.001). Reviewing the decision aid from the Centers for Disease Control or the American Academy of Family Physicians did not alter the likelihood (each p >0.2). However, the decision aid from the United States Preventive Services Task Force was associated with the largest decrease in screening preference (–16.0, p <0.001). Participants reported increased comfort (from 3.5 to 4.1 of 5) with the decision making process of prostate cancer screening following exposure to a decision aid (p <0.001). Conclusions: Exposure to a decision aid decreased the participant likelihood of undergoing or recommending prostate cancer screening and increased comfort with the screening process.
KW - decision support techniques
KW - early detection of cancer
KW - prostate-specific antigen
KW - prostatic neoplasms
KW - surveys and questionnaires
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U2 - 10.1016/j.juro.2018.05.093
DO - 10.1016/j.juro.2018.05.093
M3 - Article
C2 - 29852180
AN - SCOPUS:85053625280
SN - 0022-5347
VL - 200
SP - 1048
EP - 1055
JO - Journal of Urology
JF - Journal of Urology
IS - 5
ER -