Effects of a Decision Support Intervention on Decisional Conflict Associated with Microsatellite Instability Testing

Abstract

Background: Decision support to facilitate informed consent is increasingly important for complicated medical tests. Here, we test a theoretical model of factors influencing decisional conflict in a study examining the effects of a decision support aid that was designed to assist patients at high risk for hereditary nonpolyposis colorectal cancer (CRC) deciding whether to pursue the microsatellite instability (MSI) test.Methods: Participants were 239 CRC patients at high familial risk for a genetic mutation who completed surveys before and after exposure to the intervention. Half of the sample was assigned to the CD-ROM aid and half received a brief description of the test. Structural equation modeling was employed to examine associations among the intervention, knowledge, pros and cons to having MSI testing, self-efficacy, preparedness, and decisional conflict.Results: The goodness of fit for the model was acceptable [FIML, full information maximum likelihood, c

The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: A multi-center randomized trial

“…Our findings are consistent with studies in other health decision settings, including the contexts of prostate cancer screening, [44–47] colorectal cancer screening [48,49] genetic testing, [50,51] breast cancer surgery [52,53] and ovarian cancer risk management. [54] Randomized trials have shown the impact of decision support interventions on reduced DC, most often measured by the total score of the DCS.…”

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients

“…According to the ODSF, 47 decision conflict is reduced by addressing contributors to uncertainty, including providing information about benefits and risks for options, helping patients understand their values and emotion reactions, and improving perceived preparedness. Studies have suggested that less preparedness 51 and knowledge 52 are associated with greater decisional conflict. 51 Thus, our results partially support the ODSF and prior work.…”

“…Studies have suggested that less preparedness 51 and knowledge 52 are associated with greater decisional conflict. 51 Thus, our results partially support the ODSF and prior work. However, knowledge, reasons to choose BR, and anxiety were not associated with decisional conflict when the other variables were included in the model, which is not consistent with the ODSF.…”

Development of a Web-based Family Intervention for BRCA Carriers and Their Biological Relatives: Acceptability, Feasibility, and Usability Study (Preprint)

“…Existing interventions targeted confirmed mutation carriers or women at risk for carrying a pathogenic mutation, and complemented the genetic counseling process by addressing primarily decision-making for genetic testing [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Other intervention outcomes include improving understanding of cancer genetics during counseling [37,[39][40][41][42][43][44][45][46]; enhancing carriers' well-being after testing [23,[47][48][49][50]; and supporting them during disclosure of genetic test results [51][52][53][54].…”