Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial

Reder, Maren; Kolip, Petra

doi:10.1371/journal.pone.0189148

Cited by 29 publications

(43 citation statements)

References 31 publications

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“…Reder and Kolip 34 compared an SB with a new DA in 50-year-old women invited to participate in a BC organised screening programmes. Both groups had a very positive attitude towards screening.…”

Section: Discussionmentioning

confidence: 99%

“…Participating women had a high level of education, which limits the generalisability of findings, in agreement with other studies. 22,31,34 Most of the participants had already had a mammography before the invitation to the organised screening programme. This suggests that many had already received information that could have fostered the attitude and intention reported in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Like the InforMa 31 and Reder 34 studies, our study was part of organised BC screening programmes, facilitating the adoption of the DA in standard practice, in addition to well-balanced informative leaflets, as the one developed within our study.…”

Section: Discussionmentioning

confidence: 99%

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A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

et al. 2020

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BACKGROUND: Improving the quality of information and communication is a priority in organised breast cancer screening and an ethical duty. Programmes must offer the information each woman is looking for, promoting informed decision-making. This study aimed to develop and evaluate a web-based dynamic decision aid (DA). METHODS: A pragmatic randomised trial carried out in six regional organised screening programmes recruited women at the first invitation receiving DA or a web-based standard brochure (SB). The primary outcome was informed choice measured on knowledge, attitudes, and intentions. Follow-up period: 7-10 days. Secondary outcomes included participation rate, satisfaction, decisional conflict, and acceptability of DA. RESULTS: Two thousand one hundred and nineteen women were randomised and 1001 completed the study. Respectively, 43.9% and 36.9% in the DA and SB reached the informed choice. The DA gave a 13-point higher proportion of women aware about overdiagnosis compared to SB (38.3% versus 25.2%, p < 0.0001). The percentage of women attending screening was the same: 84% versus 83%. Decisional conflict was significantly lower in the DA group (14.4%) than in the SB group (19.3%). CONCLUSION: DA increases informed choice. Complete information including the pros, cons, controversies, and overdiagnosis-overtreatment issues boost a woman's knowledge without reducing the rate of actual screening participation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov number NCT 03097653.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

et al. 2020

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“…This can be for both diagnostic and therapeutic procedures. They make it easier for patients and clinicians to discuss treatment options [3–5]. A PDA has the following objectives:Inform patients of the evidence base to the available options;Enable patients to identify what is important to them so that their choices reflect their preferences and values;Encourage active participation by the patient in the decision-making process.…”

Section: Introductionmentioning

confidence: 99%

Utility of patient decision aids (PDA) in stress urinary incontinence surgery

Duckett

2019

Int Urogynecol J

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Introduction and hypothesis Patient decision aids (PDAs) facilitate shared decision making allowing patients to make decisions about their healthcare that take into account their personal values and preferences. The aim of this study was to establish whether a PDA used in women requiring stress incontinence surgery is helpful to women when making choices about the treatments they choose by using a Decision Conflict Scale (DCS). Methods Forty-five consecutive women were identified as having stress urinary incontinence and had completed all conservative treatments. All patients included in the study had stress urinary incontinence confirmed on urodynamic testing and were given the PDA at the point where they needed to make a decision about surgery. Following completion of the PDA, patients were given a DCS to complete which measures personal perceptions of uncertainty when making a decision about treatment. Results Forty-three out of 45 (95.5%) patients scored 4/4 for the DCS indicating they were sure of their decision. Two patients (4.5%) scored 3/4 and were therefore unsure of their choice. No patient scored < 3 on the DCS. The choice of procedures varied in all the ages and two women opted to have no treatment. Conclusions The use of a PDA in the surgical treatment of stress urinary incontinence reduces decision conflict and ensures patients are sure of their decision, understand the information provided as well as the risk benefit ratio of the various options and feel they have adequate support and advice to make a choice. Electronic supplementary material The online version of this article (10.1007/s00192-019-03982-1) contains supplementary material, which is available to authorized users.

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“…It was assessed with five context and one numeric question which were created based on previous research [19,20]. For more details see the study protocol [18] and previous analyses regarding the instrument [21,22]. Topics covered were (1) screening for people without symptoms, (2numeric question) frequency of positive screening results, (3) false-positives, (4) false-negatives, (5) diagnoses with the MSP, and (6) overdiagnosis and overtreatment.…”

Section: Variablesmentioning

confidence: 99%

Knowledge about mammography screening in Germany by education and migrant status – results of a cross-sectional study (InEMa)

et al. 2019

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Background: The population-based mammography screening program (MSP) is aimed to reduce breast cancer mortality, to detect breast cancer at an early stage, and to allow for less invasive treatment. However, it also has some potential harms, such as overdiagnosis and overtreatment. Therefore, it is necessary that women receive sufficient and balanced information to enable informed decision-making. We examined knowledge about benefits and harms of the MSP in Germany among first-time invitees of different socio-demographic backgrounds. Methods: This observational study assessed knowledge about benefits and harms of the MSP among women who were invited to the MSP for the first time by six multiple choice items, using a postal survey. We investigated (i) single items of knowledge, (ii) the distribution of sufficient knowledge stratified by education, migration status and invitation, and (iii) possible determinants of sufficient knowledge by analyzing Odds Ratios (ORs) using bivariate and multivariate logistic regression. Results: In total, 5397 women included in the analyses. 46.1% of the study population had sufficient knowledge about benefits and harms of the MSP. However, women with low educational level and migration background had higher proportions of insufficient knowledge and used most frequently the option "don't know". Women had the most difficulties answering the numeric question and the question about the target group correctly. Results from the logistic regression showed that the odds of having sufficient knowledge were higher among well-educated women (OR 3.84, 95%CI 3.24-4.55), among women who already received the MSP invitation (OR 1.38, 95%CI 1.20-1.59) and lowest among Turkish women (OR 0.14, 95%CI 0.07-0.25). Conclusions: Women with low education and migration background need adapted information regarding benefits and harms of the MSP and are important target groups for further developing the information material about mammography screening to reduce disparities in knowledge and enable informed decision-making.

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Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial

Cited by 29 publications

References 31 publications

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

Utility of patient decision aids (PDA) in stress urinary incontinence surgery

Knowledge about mammography screening in Germany by education and migrant status – results of a cross-sectional study (InEMa)

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