scholarly journals Evaluate the effectiveness of breast cancer decision aids: A systematic review and meta‐analysis of randomize clinical trails

Nursing Open ◽  
2020 ◽  
Author(s):  
Jin‐ping Gao ◽  
Ying‐hui Jin ◽  
Shao‐fu Yu ◽  
Wang‐feng Wu ◽  
Shi‐fan Han
2020 ◽  
Vol 9 (14) ◽  
pp. 985-1002
Author(s):  
Lin Yu ◽  
Ping Li ◽  
Shu Yang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  

Aim: Breast cancer is a leading cause of cancer among women. Because guidelines on screening for breast cancer for certain ages are controversial, many experts advocate the use of shared decision making (SDM) using validated decision aids (DAs). Recent studies have concluded that DAs are beneficial; however, the results have great heterogeneity. Therefore, further studies are needed to improve understanding of these tools. Objective: This systematic review and meta-analysis aimed to investigate the impact of using web-based DAs in women aged 50 years and below facing the decision to be screened for breast cancer in comparison with usual care. Methods: PubMed, Web of Science, Embase and the Cochrane CENTRAL databases were searched up to February 2020 for studies assessing web-based DAs for women making a breast cancer screening decision and reported quality of decision-making outcomes. Using a random-effects model or a fixed-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD) and relative risks (RR). Results: Of 1097 unique citations, three randomized controlled trials and two before–after studies met the study eligibility criteria. Compared with usual care, web-based DAs increased knowledge (SMD = 0.69; 95% CI: 0.57–0.80; p < 0.00001), reduced decision conflict and increased the proportion of women who made an informed choice (RR = 1.86; 95% CI: 1.38 to 2.50; p < 0.0001), but did not change the intention of women deciding to be screened or affect decision regret. Conclusion: This analysis showed the positive effect of web-based DAs on patient-centered outcomes in breast cancer screening. In the future, more internet devices and free or larger discount WI-FI should be established to ensure more women can benefit from this effective tool.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016894 ◽  
Author(s):  
Montserrat Martínez-Alonso ◽  
Misericòrdia Carles-Lavila ◽  
Maria José Pérez-Lacasta ◽  
Anna Pons-Rodríguez ◽  
Montse Garcia ◽  
...  

ObjectiveThe aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer.SettingScreening for breast cancer.InterventionDAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes.Eligible studiesWe included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies’ risk of bias was assessed with the Cochrane Collaboration’s tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs.Primary and secondary outcomesThe main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened.ResultsA total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The meta-analysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened.ConclusionsTools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs.


2020 ◽  
Vol 27 (37) ◽  
pp. 6373-6383 ◽  
Author(s):  
Leila Jouybari ◽  
Faezeh Kiani ◽  
Farhad Islami ◽  
Akram Sanagoo ◽  
Fatemeh Sayehmiri ◽  
...  

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.


2019 ◽  
Vol 12 (8) ◽  
pp. 815-824 ◽  
Author(s):  
Anne Julienne Genuino ◽  
Usa Chaikledkaew ◽  
Due Ong The ◽  
Thanyanan Reungwetwattana ◽  
Ammarin Thakkinstian

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