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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

The effects of shared decision-making compared to usual care for prostate cancer screening decisions: a systematic review and meta-analysis

Authors: Nahara Anani Martínez-González, Stefan Neuner-Jehle, Andreas Plate, Thomas Rosemann, Oliver Senn

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Shared decision-making (SDM) is recommended for men facing prostate cancer (PC) screening decisions. We synthesize the evidence on the comparative effectiveness of SDM with usual care.

Methods

We searched academic and grey literature databases, and other sources for primary randomised controlled trials (RCTs) published in English comparing SDM to usual care and conducted in primary and specialised care. We assessed the individual study risk of bias, and calculated the study-specific and pooled relative risks (RR) or standardised mean differences (SMD) [with 95% confidence intervals (CI)] to perform random-effects meta-analyses for SDM-related and patient outcomes.

Results

Four RCTs comparing SDM to usual care, involving 1760 men, were included. SDM improved knowledge (SMD 0.23, 95%CI 0.02 to 0.43; 2 RCTs), but was not different to usual care in reducing either patient participation in prostate-specific antigen (PSA) testing (RR 1.03, 95%CI 0.90 to 1.19; 2 RCTs) or decisional conflict (SMD -0.04, 95%CI -0.23 to 0.15; SMD -0.05, 95%CI -0.24 to 0.14; 2 RCTs). Individual trial estimates (46.7%) also suggest that SDM may reduce or neutralise physicians’ tendency for PSA screening, and may improve the accuracy of patients’ perception of lifetime-risks and men’s views towards screening. There was no evidence on the effects of SDM on health outcomes. The studies represent various interventions and outcomes and are prone to risk of bias.

Conclusions

There is currently insufficient evidence to support a clear association of SDM on patient- and SDM-related outcomes for decisions about PSA testing. Further research needs to assess the clinical effectiveness of SDM using well-defined SDM interventions and outcomes. It should address the absence of evidence, particularly on health outcomes.
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Literature
1.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRef
2.
Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, Bray F. International variation in prostate Cancer incidence and mortality rates. Eur Urol. 2012;61(6):1079–92.CrossRef
3.
Kicinski M, Vangronsveld J, Nawrot TS. An epidemiological reappraisal of the familial aggregation of prostate cancer: a meta-analysis. PLoS One. 2011;6(10):e27130.CrossRef
4.
Melia J. Part 1: the burden of prostate cancer, its natural history, information on the outcome of screening and estimates of ad hoc screening with particular reference to England and Wales. BJU Int. 2005;95(Suppl 3):4–15.CrossRef
5.
Schroder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, Kwiatkowski M, Lujan M, Lilja H, Zappa M, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360(13):1320–8.CrossRef
6.
Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB, Carroll P, Etzioni R. Overdiagnosis and overtreatment of prostate cancer. Eur Urol. 2014;65(6):1046–55.CrossRef
7.
Pinsky PF, Prorok PC, Yu K, Kramer BS, Black A, Gohagan JK, Crawford ED, Grubb RL, Andriole GL. Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years. Cancer. 2017;123(4):592–9.CrossRef
8.
Andriole GL, Crawford ED, Grubb RL 3rd, Buys SS, Chia D, Church TR, Fouad MN, Isaacs C, Kvale PA, Reding DJ, et al. Prostate cancer screening in the randomized prostate, lung, colorectal, and ovarian Cancer screening trial: mortality results after 13 years of follow-up. J Natl Cancer Inst. 2012;104(2):125–32.CrossRef
9.
Sandblom G, Varenhorst E, Rosell J, Lofman O, Carlsson P. Randomised prostate cancer screening trial: 20 year follow-up. BMJ. 2011;342:d1539.CrossRef
10.
Schroder FH, Hugosson J, Roobol MJ, Tammela TL, Zappa M, Nelen V, Kwiatkowski M, Lujan M, Maattanen L, Lilja H, et al. Screening and prostate cancer mortality: results of the European randomised study of screening for prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384(9959):2027–35.CrossRef
11.
Schroder FH, Hugosson J, Carlsson S, Tammela T, Maattanen L, Auvinen A, Kwiatkowski M, Recker F, Roobol MJ. Screening for prostate cancer decreases the risk of developing metastatic disease: findings from the European randomized study of screening for prostate Cancer (ERSPC). Eur Urol. 2012;62(5):745–52.CrossRef
12.
Labrie F, Candas B, Cusan L, Gomez JL, Belanger A, Brousseau G, Chevrette E, Levesque J. Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial. Prostate. 2004;59(3):311–8.CrossRef
13.
Donovan JL, Hamdy FC, Lane JA, Mason M, Metcalfe C, Walsh E, Blazeby JM, Peters TJ, Holding P, Bonnington S, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2016;375(15):1425–37.CrossRef
14.
Heijnsdijk EAM, de Carvalho TM, Auvinen A, Zappa M, Nelen V, Kwiatkowski M, Villers A, Páez A, Moss SM, Tammela TLJ, et al. Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. J Natl Cancer Inst. 2015;107(1):dju366.CrossRef
15.
Grossman DC, Curry SJ, Owens DK, Bibbins-Domingo K, Caughey AB, Davidson KW, Doubeni CA, Ebell M, Epling JW Jr, Kemper AR, et al. Screening for prostate Cancer: US preventive services task force recommendation statement. JAMA. 2018;319(18):1901–13.CrossRef
16.
Fenton JJ, Weyrich MS, Durbin S, Liu Y, Bang H, Melnikow J. Prostate-specific antigen–based screening for prostate cancer: evidence report and systematic review for the US preventive services task force. JAMA. 2018;319(18):1914–31.CrossRef
17.
Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, Fossati N, Gross T, Henry AM, Joniau S, et al. EAU-ESTRO-SIOG guidelines on prostate Cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2017;71(4):618–29.CrossRef
18.
Harris RP, Wilt TJ, Qaseem A. A value framework for cancer screening: advice for high-value care from the American college of physicians. Ann Intern Med. 2015;162(10):712–7.CrossRef
19.
Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, Holmberg L, Kantoff P, Konety BR, Murad MH, et al. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190(2):419–26.CrossRef
20.
Gondos A, Krilaviciute A, Smailyte G, Ulys A, Brenner H. Cancer surveillance using registry data: results and recommendations for the Lithuanian national prostate cancer early detection programme. Eur J Cancer. 2015;51(12):1630–7.CrossRef
21.
22.
Parker C, Gillessen S, Heidenreich A, Horwich A. Cancer of the prostate: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):v69–77.CrossRef
23.
Bell N, Connor Gorber S, Shane A, Joffres M, Singh H, Dickinson J, Shaw E, Dunfield L, Tonelli M. Recommendations on screening for prostate cancer with the prostate-specific antigen test. Can Med Assoc J. 2014;186(16):1225–34.CrossRef
24.
Carlsson S, Leapman M, Carroll P, Schroder F, Albertsen PC, Ilic D, Barry M, Frosch DL, Vickers A. Who and when should we screen for prostate cancer? interviews with key opinion leaders. BMC Med. 2015;13:288.CrossRef
25.
Stiggelbout AM, Van der Weijden T, De Wit MP, Frosch D, Legare F, Montori VM, Trevena L, Elwyn G. Shared decision making: really putting patients at the Centre of healthcare. BMJ. 2012;344:e256.CrossRef
26.
Coulter A, Parsons S, Askham J. Health systems and policy analysis. Policy brief: where are the patients in decision-making about their own care? In. European Observatory on Health Systems and Policies, WHO Regional Office for Europe: Copenhagen; 2008.
27.
Legare F, Stacey D, Turcotte S, Cossi MJ, Kryworuchko J, Graham ID, Lyddiatt A, Politi MC, Thomson R, Elwyn G, et al. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2014;(9):CD006732.
28.
Mulley AG, Trimble C, Elwyn G. Stop the silent misdiagnosis: patients’ preferences matter. BMJ. 2012;345:e6572.CrossRef
29.
Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49(5):651–61.CrossRef
30.
Elwyn G, Frosch D, Rollnick S. Dual equipoise shared decision making: definitions for decision and behaviour support interventions. Implement Sci. 2009;4(1):75.CrossRef
31.
Martinez-Gonzalez NA, Plate A, Senn O, Markun S, Rosemann T, Neuner-Jehle S. Shared decision-making for prostate cancer screening and treatment: a systematic review of randomised controlled trials. Swiss Med Wkly. 2018;148:w14584.PubMed
32.
Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;(1):CD001431.
33.
Egger M, Smith GD, Altman DG. Principles of and procedures for systematic reviews. In: Egger M, Smith GD, Altman DG, editors. Systematic reviews in health care. 2nd ed. London: BMJ Publishing Group; 2008. p. 23–42.
34.
35.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.CrossRef
36.
Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681–92.CrossRef
37.
Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, Cording E, Tomson D, Dodd C, Rollnick S, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361–7.CrossRef
38.
Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Mak. 2015;35(1):114–31.CrossRef
39.
Juni P, Witschi A, Bloch R, Egger M. The hazards of scoring the quality of clinical trials for meta-analysis. JAMA. 1999;282(11):1054–60.CrossRef
40.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.CrossRef
41.
Wilkes MS, Day FC, Srinivasan M, Griffin E, Tancredi DJ, Rainwater JA, Kravitz RL, Bell DS, Hoffman JR. Pairing physician education with patient activation to improve shared decisions in prostate cancer screening: a cluster randomized controlled trial. Ann Fam Med. 2013;11(4):324–34.CrossRef
42.
Landrey AR, Matlock DD, Andrews L, Bronsert M, Denberg T. Shared decision making in prostate-specific antigen testing: the effect of a mailed patient flyer prior to an annual exam. J Prim Care Community Health. 2013;4(1):67–74.CrossRef
43.
Krist AH, Woolf SH, Johnson RE, Kerns JW. Patient education on prostate cancer screening and involvement in decision making. Ann Fam Med. 2007;5(2):112–9.CrossRef
44.
Woolf SH, Krist AH, Johnson RE, Stenborg PS. Unwanted control: how patients in the primary care setting decide about screening for prostate cancer. Patient Educ Couns. 2005;56(1):116–24.CrossRef
45.
Gattellari M, Ward JE. Does evidence-based information about screening for prostate cancer enhance consumer decision-making? a randomised controlled trial. J Med Screen. 2003;10(1):27–39.CrossRef
46.
van der Weijden T, Post H, Brand PLP, van Veenendaal H, Drenthen T, van Mierlo LA, Stalmeier P, Damman OC, Stiggelbout A. Shared decision making, a buzz-word in the Netherlands, the pace quickens towards nationwide implementation. Z Evid Fortbild Qual Gesundhwes. 2017;123–124:69–74.CrossRef
47.
Reyna VF, Nelson WL, Han PK, Dieckmann NF. How numeracy influences risk comprehension and medical decision making. Psychol Bull. 2009;135(6):943–73.CrossRef
48.
DeWalt DA, Malone RM, Bryant ME, Kosnar MC, Corr KE, Rothman RL, Sueta CA, Pignone MP. A heart failure self-management program for patients of all literacy levels: a randomized, controlled trial. BMC Health Serv Res. 2006;6:30.CrossRef
49.
Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns. 2006;60(3):301–12.CrossRef
Metadata
Title
The effects of shared decision-making compared to usual care for prostate cancer screening decisions: a systematic review and meta-analysis
Authors
Nahara Anani Martínez-González
Stefan Neuner-Jehle
Andreas Plate
Thomas Rosemann
Oliver Senn
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4794-7

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