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

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  • Sheridan, Stacey
    • Affiliation: Cecil G. Sheps Center for Health Services Research
  • Golin, Carol E.
    • Affiliation: Cecil G. Sheps Center for Health Services Research
  • Bunton, Audrina
    • Affiliation: Cecil G. Sheps Center for Health Services Research
  • Lykes, John B
    • Affiliation: Cecil G. Sheps Center for Health Services Research
  • Schwartz, Bob
    • Affiliation: Cecil G. Sheps Center for Health Services Research
  • McCormack, Lauren
    • Other Affiliation: RTI International, Research Triangle Park, NC, USA
  • Driscoll, David
    • Other Affiliation: RTI International, Research Triangle Park, NC, USA
  • Bangdiwala, Shrikant
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Harris, Russell
    • Affiliation: Cecil G. Sheps Center for Health Services Research
Abstract
  • 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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  • Article
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  • In Copyright
Rights holder
  • Stacey L Sheridan et al.; licensee BioMed Central Ltd.
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Journal title
  • BMC Medical Informatics and Decision Making
Journal volume
  • 12
Journal issue
  • 1
Page start
  • 130
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1472-6947
Bibliographic citation
  • BMC Medical Informatics and Decision Making. 2012 Nov 13;12(1):130
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • February 26, 2013

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file details 1472-6947-12-130.pdf 2019-05-06 Public Download
file details Coaching Tool Detail. 2019-05-06 Public Download
file details 1472-6947-12-130.xml 2019-05-06 Public Download
file details Results by City. 2019-05-06 Public Download
file details The Effect of the Intervention on Changes in Key Components of Decision Making. 2019-05-06 Public Download