1249 THE ROLE OF PERSONALIZED CHOICE: A RANDOMIZED CONTROLLED TRIAL OF AN ONLINE DECISION AID FOR PROSTATE CANCER SCREENING

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening (I)1 Apr 20131249 THE ROLE OF PERSONALIZED CHOICE: A RANDOMIZED CONTROLLED TRIAL OF AN ONLINE DECISION AID FOR PROSTATE CANCER SCREENING Glenn Salkeld, Michelle Cunich, Jack Dowie, Kirsten Howard, Graham Mann, and Manish Patel Glenn SalkeldGlenn Salkeld Sydney, Australia More articles by this author , Michelle CunichMichelle Cunich Sydney, Australia More articles by this author , Jack DowieJack Dowie London, United Kingdom More articles by this author , Kirsten HowardKirsten Howard Sydney, Australia More articles by this author , Graham MannGraham Mann Sydney, Australia More articles by this author , and Manish PatelManish Patel Sydney, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2603AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Personalised decision making in health requires at least three key components: evidence on the benefits, harms, costs and other important factors relevant to the decision; the capacity to express personal preferences; and the integration of evidence and preferences to form an opinion or recommendation. The purpose of this study was to assess the role of personalizing the content of an online and interactive decision aid for prostate cancer screening (using the Prostate Specific Antigen test ? PSA) with the outcome measured in terms of a personalised measure of decision quality. METHODS A randomized controlled trial design in which a community sample of men aged 40-49yrs, 50-59yrs and 60-69 years with no additional risk factors for prostate cancer were allocated to an intervention or active comparator group. The intervention group were asked to complete an online decision aid for prostate cancer screening in which the content was personalized to the participant. The participants were asked to choose as few or many of the following 10 attributes to populate their online decision aid: life expectancy, general health, unnecessary biopsy, overdiagnosis, urinary problems, bowel problems, sexual problems, burden of treatment, carer burden, and regret. The active comparator group was asked to complete an online decision aid where the content was fixed to five key attributes relating to the benefit, harms and process of PSA screening. The primary outcome was decision quality as measure by the MDQ (MyDecisionQuality) continuous scale. Other outcomes included the stated choice to have a PSA test. RESULTS There were 727 men in the “fixed attribute” comparator group and 720 men in the personalized decision aid intervention group. 43% of respondents in the “fixed attribute” and 40% in the “personalised DA” group had had a PSA test in the past 12 months. 60% of men in both groups had seen their primary care physician in the past 12 months. There was a significant difference in the mean “Quality of Decision” score (MDQ=0.71 in the personalized DA group compared to 0.68 in the fixed attribute group). Having gone through the on-line decision aid, only 5% of men in the “fixed attribute” group preferred the PSA test option over the no test option whereas 64% of men in the “personalised DA” group would have a PSA test. CONCLUSIONS The inclusion of psychosocial attributes in a personalized DA, including the notion of “regret”, had a significant impact on men's post decision aid preferences for PSA testing. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e511 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn Salkeld Sydney, Australia More articles by this author Michelle Cunich Sydney, Australia More articles by this author Jack Dowie London, United Kingdom More articles by this author Kirsten Howard Sydney, Australia More articles by this author Graham Mann Sydney, Australia More articles by this author Manish Patel Sydney, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...