Value Attribution in the Decision to Use of Whole Body MRI for Early Cancer Diagnosis.

Derna Busacchio,Ketti Mazzocco,Paola Pricolo,Gabriella Pravettoni,Giuseppe Petralia,Davide Radice,Paul E Summers

doi:10.3390/diagnostics11060972

Abstract

This study aimed to identify the main factors that asymptomatic individuals considered when deciding to undergo self-referred Whole-body MRI (WB-MRI) for early cancer diagnosis and the subjective values attributed to each mentioned factor in a Decision tree analysis. Personal characteristics such as risk perception and personality were investigated as possible factors affecting value attribution. Seventy-four volunteers (mean age 56.4; male = 47) filled a simplified decision tree by expressing the expected factors and related subjective values associated with two screening options for early cancer diagnosis (standard procedures vs. WB-MRI+standard procedures) while waiting for a WB-MRI examination. Questionnaires on risk perception and personality traits were also administered. Expected factors were summarized in 5 clusters: diagnostic certainty, psychological well-being, safety, test validity and time/cost. Test validity and time/cost were evaluated as potential losses in both procedures. Diagnostic Certainty and safety were evaluated as losses in standard screening, and as an advantage when considering WB-MRI+standard screening. Forty-five percent of participants considered WB-MRI+standard screening as beneficial for their psychological well-being. Finally, personal absolute and comparative risk to get cancer was associated with a positive value attribution to WB-MRI (p < 0.05). Our results showed the addition of WB-MRI to be generally considered a good option to increase individuals’ perceptions of diagnostic certainty and the safety of the exam, and to increase psychological well-being. The positive value of such a screening option increased with the individual’s cancer risk perception.

Highlights

Given the growing interest in the adoption of Whole-body MRI (WB-MRI) for early cancer diagnosis, assessing factors that move healthy people to adopt this new technology may help physicians and health institutions to tailor communication to facilitate individuals’ understanding and decision making regarding such screening
This study aimed to identify the main factors that asymptomatic individuals considered when deciding to undergo self-referred Whole-body MRI (WB-MRI) for early cancer diagnosis and the subjective values attributed to each mentioned factor in a Decision tree analysis
Considering that WB-MRI is an adjunct to the standard procedure and not a substitution, our results show the differences in individuals’ mental representation and value attribution about WB-MRI and standard cancer screening options in Italy

Summary

Introduction

Given the growing interest in the adoption of Whole-body MRI (WB-MRI) for early cancer diagnosis, assessing factors that move healthy people to adopt this new technology may help physicians and health institutions to tailor communication to facilitate individuals’ understanding and decision making regarding such screening. The lack of radiation exposure and absence of contrast-agent administration in a typical WB-MRI examination, contribute to its attractiveness for early cancer diagnosis, as an adjunct to standard screening examinations. WB-MRI can be performed at one’s own expense, as an adjunct to standard screening examinations (mammography, pap-test, FOBT and PSA) provided by National Health Service. Risk perception can guide protective actions, such as screening for cancer, quitting smoking [4], nutrition habits and physical activity [5,6]. The judgments people make about their risk of developing cancer have important implications for cancer prevention, screening and treatment [7,8,9,10]

Objectives

Results

Conclusion