Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: A randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested

2006 ◽  
Vol 63 (3) ◽  
pp. 367-379 ◽  
Author(s):  
Eila Watson ◽  
Paul Hewitson ◽  
Joanne Brett ◽  
Colleen Bukach ◽  
Rhodri Evans ◽  
...  
Keyword(s):  
Decision Aid ◽  
Controlled Trial ◽  
Specific Antigen ◽  
Informed Decision Making ◽  
Patient Decision Aid ◽  
Psa Testing ◽  
Patient Decision ◽  
Randomised Controlled ◽  
The Impact ◽  
Men’S Knowledge

scholarly journals Assessing Preference Shift and Effects on Patient Knowledge and Decisional Conflict: Cross-Sectional Study of an Interactive Prostate-Specific Antigen Test Patient Decision Aid (Preprint)

2018 ◽  
Author(s):  
Peter Scalia ◽  
Glyn Elwyn ◽  
Jan Kremer ◽  
Marjan Faber ◽  
Marie-Anne Durand
Keyword(s):  
Prostate Specific Antigen ◽  
Decision Aid ◽  
Specific Antigen ◽  
Decisional Conflict ◽  
Patient Decision Aid ◽  
Web Based ◽  
Psa Test ◽  
Psa Testing ◽  
Patient Decision ◽  
The Web

BACKGROUND Randomized trials of Web-based decision aids for prostate-specific antigen (PSA) testing indicate that these interventions improve knowledge and reduce decisional conflict. However, we do not know about these tools’ impact on people who spontaneously use a PSA testing patient decision aid on the internet. OBJECTIVE The objectives of this study were to (1) determine the impact of the Web-based PSA Option Grid patient decision aid on preference shift, knowledge, and decisional conflict; (2) identify which frequently asked questions (FAQs) are associated with preference shift; and (3) explore the possible relationships between these outcomes. METHODS Data were collected between January 1, 2016, and December 30, 2017. Users who accessed the Web-based, interactive PSA Option Grid were provided with 3 options: have a PSA test, no PSA test, or unsure. Users first declared their initial preference and then completed 5 knowledge questions and a 4-item (yes or no) validated decisional conflict scale (Sure of myself, Understand information, Risk-benefit ratio, Encouragement; SURE). Next, users were presented with 10 FAQs and asked to identify their preference for each question based on the information provided. At the end, users declared their final preference and completed the same knowledge and decisional conflict questions. Paired sample t tests were employed to compare before and after knowledge and decisional conflict scores. A multinomial regression analysis was performed to determine which FAQs were associated with a shift in screening preference. RESULTS Of all the people who accessed the PSA Option Grid, 39.8% (186/467) completed the interactive journey and associated surveys. After excluding 22 female users, we analyzed 164 responses. At completion, users shifted their preference to “not having the PSA test” (43/164, 26.2%, vs 117/164, 71.3%; P<.001), had higher levels of knowledge (112/164, 68.3%, vs 146/164, 89.0%; P<.001), and lower decisional conflict (94/164, 57.3%, vs 18/164, 11.0%; P<.001). There were 3 FAQs associated with preference shift: “What does the test involve?” “If my PSA level is high, what are the chances that I have prostate cancer?” and “What are the risks?” We did not find any relationship between knowledge, decisional conflict, and preference shift. CONCLUSIONS Unprompted use of the interactive PSA Option Grid leads to preference shift, increased knowledge, and reduced decisional conflict, which confirms the ability of these tools to influence decision making, even when used outside clinical encounters.

Prospective evaluation of a new patient decision aid to enhance prostate cancer screening decision-making.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 87-87
Author(s):  
Michael Austin Brooks ◽  
Anita Misra-Hebert ◽  
Alexander Zajichek ◽  
Sigrid V. Carlsson ◽  
Jonas Hugosson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Health Literacy ◽  
Decision Aid ◽  
Decisional Conflict ◽  
Patient Decision Aid ◽  
Psa Screening ◽  
Psa Testing ◽  
Patient Decision ◽  
The Impact

87 Background: We previously developed screening nomograms to predict 15-year risk of all-cause mortality, prostate cancer diagnosis, and prostate cancer mortality, and incorporated them into a graphical patient decision aid (PtDA). Our objective was to prospectively recruit primary care patients interested in shared-decision making regarding prostate specific antigen (PSA) screening and assess the impact of individualized counseling using our new PtDA. Methods: 50 patients from one internal medicine practice were enrolled in a single-arm sequential trial design, with face-to-face clinician counseling and questionnaires. Eligibility criteria included men age 50-69 years old and life expectancy > 10 years. Patients were excluded for a personal history of prostate cancer or PSA screening within the prior year. Participants completed baseline questionnaires regarding prior PSA testing, demographic information, health literacy, and the Control Preferences Scale (CPS). They then received standardized counseling (based on large trial and epidemiologic data) regarding PSA screening, followed by individualized counseling using our new PtDA. Participants then made a screening decision, and completed a post decision questionnaire including a Decisional Conflict Scale. Results: The median age was 60 (IQR 54; 65). 41 (82%) had a prior PSA test, while 9 (18%) had not. 42 (84%) of participants received some education beyond high school, 41 (82%) demonstrated high health literacy, and 45 (90%) desired to have an active role in decision-making based on the CPS. After undergoing counseling, 34 (68%) participants chose to undergo initial or repeat PSA screening, 8 (16%) chose against future screening, and 8 (16%) remained uncertain. 45 (90%) participants found individualized counseling using the PtDA more useful than standardized counseling. Finally, patients reported reduced decisional conflict compared to historical controls (P < 0.001). Conclusions: Our process of standardized counseling followed by individualized counseling using our new PtDA was effective in reducing decisional conflict. The majority of participants found the PtDA more useful for decision making than standardized counseling. Clinical trial information: NCT03387527.

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