Decision aids for breast cancer screening in women approximately 50 years of age: A systematic review and meta‐analysis of randomised controlled trials

2021 ◽  
Author(s):  
Lin Yu ◽  
Shu Yang ◽  
Chunmiao Zhang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Decision Aids ◽  
Controlled Trials ◽  
Randomised Controlled

Web-based decision aids to support breast cancer screening decisions: systematic review and meta-analysis

2020 ◽  
Vol 9 (14) ◽  
pp. 985-1002
Author(s):  
Lin Yu ◽  
Ping Li ◽  
Shu Yang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Cancer Screening ◽  
Usual Care ◽  
Breast Cancer Screening ◽  
Meta Analysis ◽  
Decision Aids ◽  
Web Based ◽  
Mean Differences

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.

Breast Cancer Screening: The Effect of Self Selection for Screening on Comparisons of Randomised Controlled Trials

1997 ◽  
Vol 4 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Ann Richardson ◽  
J Elisabeth Wells
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Randomised Controlled Trials ◽  
Intervention Group ◽  
Controlled Trials ◽  
Self Selection ◽  
Selection For ◽  
Randomised Controlled ◽  
Selection Of

In randomised controlled trials of breast cancer screening women are randomly allocated to an intervention group that is offered screening, or a control group that receives the usual medical care. Not all women in the intervention group accept screening; the women who do so may differ from other women in their underlying risk of breast cancer. This self selection for screening can result in either women at high risk or at low risk being overrepresented in the screened group. When comparisons between trials are made it is important to take self selection for screening into account, as a trial with self selection of women at high risk has the potential to have greater efficacy than a trial with self selection of women at low risk. A method of adjusting for self selection when comparing randomised controlled trials of breast cancer screening is described.

scholarly journals Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

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 ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Meta Analysis ◽  
Decision Aids ◽  
Informed Choice ◽  
Decisional Conflict ◽  
Informed Decision ◽  
Secondary Outcomes

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.

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