Use of patient decision aids increased younger women’s reluctance to begin screening mammography: a systematic review and meta-analysis

Ivlev, Ilya; Hickman, Erin N.; McDonagh, Marian; Eden, Karen

doi:10.1007/s11606-017-4027-9

Cited by 32 publications

(21 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A systematic review found that the use of decision aids made younger women (those around the age at which women begin to receive screening invitations) reluctant to participate in breast cancer screening programs (12). In our study, we found no differences in age between the intervention and control groups.…”

Section: Comparison With Previous Studiescontrasting

confidence: 63%

See 1 more Smart Citation

Effect of an Information Leaflet on Breast Cancer Screening Participation. A Randomized Controlled Study

Montero-Moraga¹,

Posso²,

Román³

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective: To evaluate the impact of an information leaflet about the risk-benefit balance of breast cancer screening on women’s participation.Methods: This randomized controlled study was conducted within a population-based breast cancer screening program and included women from the catchment areas of two hospitals in Barcelona, Spain. We evaluated women aged 50-69 years invited to screening between September 2019 and January 2020. One hospital attended a population with a lower socioeconomic status than the other. The intervention group received an information leaflet on the benefits and harms of mammography screening. The control group received the usual invitation letter. We compared the participation rate between groups, stratified by hospital and by per-protocol and intention-to-treat analyses. Results: We included 11,119 women in the study: 5,416 in the intervention group and 5,703 in the control group. A total of 36.4% (1,964/5,393) of the women in the intervention group and 37.5% (2,135/5,694) of those in the control group attended screening, respectively. Overall, we found no differences in participation among groups (difference in participation -1.1%; 95% CI; -2.9% to 0.7%, p-value=0.240). In the hospital attending a population with a low socioeconomic status, attendance was lower in the intervention group (-1.4%, 95% CI: -5.7% to -0.03%, p-value=0.029). In the per-protocol analysis, participation was lower in the intervention group (-2.6%, 95% CI: -4.6% to -0.5%, p-value=0.015). Conclusions: Overall participation in our program was unaffected by a new information leaflet on the risk-benefit balance of breast cancer screening. However, participation was lower in certain populations with lower socioeconomic status.

show abstract

Section: Comparison With Previous Studiescontrasting

confidence: 63%

“…Few studies have assessed the effect of materials providing information on the bene ts and adverse effects of screening programs on participation. Among published studies, most have measured intention to participate, and few have studied effects on screening participation (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Effect of an Information Leaflet on Breast Cancer Screening Participation. A Randomized Controlled Study

Montero-Moraga¹,

Posso²,

Román³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…[37][38][39] At the same time, for women who are already confused by current screening guideline changes, choosing screening frequency based on personal risk may be cognitively overwhelming given lack of information or validated risk-assessment tools. 40,41 Confusion about or resistance to risk-based screening will be exacerbated if there is distrust of doctors and the healthcare industry, which we found in the present study. For instance, some participants questioned if guideline changes and the proposal of risk-based screening (especially the proposal of reducing screening frequency when individual risk is low) were driven by financial concerns rather than scientific evidence, which made them resistant to risk-based screening.…”

Section: Discussionmentioning

confidence: 60%

How Do Women View Risk-Based Mammography Screening? A Qualitative Study

Schifferdecker

Ozanne

et al. 2018

J GEN INTERN MED

View full text Add to dashboard Cite

show abstract

“…To our knowledge, it is the first systematic review to assess the quality of decision aids for women who are at average risk of breast cancer and are eligible for mammographic screening using international criteria. Four high‐quality reviews had previously been performed, focusing on the effect of decision aids on various variables: informed choice, 57 knowledge, 58 intention to undergo mammography, 59 and the decision‐making process 10 …”

Section: Discussionmentioning

confidence: 99%

Quality of decision aids developed for women at average risk of breast cancer eligible for mammographic screening: Systematic review and assessment according to the International Patient Decision Aid Standards instrument

Hild

Johanet

Valenza

et al. 2020

Cancer

View full text Add to dashboard Cite

Mammographic screening contributes to a reduction in specific mortality, but it has disadvantages. Decision aids are tools designed to support people's decisions. Because these aids influence patient choice, their quality is crucial. The objective of the current study was to conduct a systematic review of decision aids developed for women eligible for mammographic screening who have an average breast cancer risk and to assess the quality of these aids. The systematic review included articles published between January 1, 1997, and August 1, 2019, in the PubMed, Embase, Cochrane, and PsycInfo databases. The studies were reviewed independently by 2 reviewers. Any study containing a decision aid for women eligible for mammographic screening with an average breast cancer risk was included. Two doubleblind reviewers assessed the quality of the selected decision aids using the International Patient Decision Aid Standards instrument, version 3 (IPDASi). Twenty-three decision aids were extracted. Classification of decision aid quality using the IPDASi demonstrated large variations among the decision aids (maximum IPDASi score, 188; mean ± SD score, 132.6 ± 23.8; range, 85-172). Three decision aids had high overall scores. The 3 best-rated dimensions were disclosure (maximum score, 8; mean score, 6.8), focusing on transparency; information (maximum score, 32; mean score, 26.1), focusing on the provision of sufficient details; and probabilities (maximum score, 32; mean score 25), focusing on the presentation of probabilities. The 3 lowest-rated dimensions were decision support technology evaluation (maximum score, 8; mean score, 4.3), focusing on the effectiveness of the decision aid; development (maximum score, 24; mean score, 12.6), evaluating the development process; and plain language (maximum score, 4; mean score, 1.9), assessing appropriateness for patients with low literacy. The results of this review identified 3 high-quality decision aids for breast cancer screening. Cancer 2020;126:2765-2774.Breast cancer is the leading cause of women's mortality worldwide. 1 Screening programs based on mammography lead to a 15% to 20% reduction in specific mortality. 2,3 However, assessing the benefits and harms of these programs requires taking into account the biases and disadvantages of mammographic screening. 2 The most important harms of this screening are false-positive results, overdiagnosis, overtreatment, and radiation-induced cancer. 4 The cumulative risk of a false-positive result ranges from 3% to 63% for a woman exposed to annual mammographic screening between ages 50 and 70 years. 5,6 In this context, clinicians may feel uncomfortable submitting their patients to this screening process without using a shared decision-making process. 7 There is now a consensus that patients should have the opportunity to participate in decisions about their health. 8,9 They should understand whether there are options and the related consequences of these options. Patient preferences should be integrated into decision making. 10 Decis...

show abstract

Use of patient decision aids increased younger women’s reluctance to begin screening mammography: a systematic review and meta-analysis

Abstract: The protocol of this review is registered in the PROSPERO database, #CRD42016036695.

Cited by 32 publications

References 38 publications

Effect of an Information Leaflet on Breast Cancer Screening Participation. A Randomized Controlled Study

Effect of an Information Leaflet on Breast Cancer Screening Participation. A Randomized Controlled Study

How Do Women View Risk-Based Mammography Screening? A Qualitative Study

Quality of decision aids developed for women at average risk of breast cancer eligible for mammographic screening: Systematic review and assessment according to the International Patient Decision Aid Standards instrument

Contact Info

Product

Resources

About