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BMC Medical Informatics and Decision Making

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Open Access 01-12-2012 | Research article

Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

Authors: Stacey L Sheridan, Carol Golin, Audrina Bunton, John B Lykes, Bob Schwartz, Lauren McCormack, David Driscoll, Shrikant I Bangdiwala, Russell P Harris

Published in: BMC Medical Informatics and Decision Making | Issue 1/2012

Abstract

Background

Professional societies recommend shared decision making (SDM) for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1) examine the effects of a prostate cancer screening intervention to promote SDM and 2) determine whether framing prostate information in the context of other clearly beneficial men’s health services affects decisions.

Methods

We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men’s health services). For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials). Within each practice site, we randomized men to either 1) a video-based decision aid and researcher-led coaching session or 2) a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician.

Results

Compared to an attention control, our prostate cancer screening intervention increased men’s perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57%) and men’s knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%), but had no effect on men’s self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference −34%; 95% CI −50% to −18%) and actual screening rates (absolute difference −22%; 95% CI −38 to −7%) with no difference in effect by frame.

Conclusions

SDM interventions can increase men’s knowledge, alter their perceptions of prostate cancer screening, and reduce actual screening. However, they may not guarantee an increase in shared decisions.

Trial registration

#NCT00630188

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6947/12/130/prepub

Title: Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials
Authors: Stacey L Sheridan
Carol Golin
Audrina Bunton
John B Lykes
Bob Schwartz
Lauren McCormack
David Driscoll
Shrikant I Bangdiwala
Russell P Harris
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Medical Informatics and Decision Making / Issue 1/2012
Electronic ISSN: 1472-6947
DOI: https://doi.org/10.1186/1472-6947-12-130

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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