Prostate Cancer Screening Patient Decision Aids: A Systematic Review and Meta-analysis

Ilya Ivlev, Silvie Jerabkova, Meenakshi Mishra, Lily A. Cook, Karen Eden

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Context: Although screening recommendations for prostate cancer using prostate-specific antigen testing often include shared decision making, the effect of patient decision aids on patients’ intention and uptake is unclear. This study aimed to review the effect of decision aids on men's screening intention, screening utilization, and the congruence between intentions and uptake. Evidence acquisition: Data sources were searched through April 6, 2018, and included MEDLINE, Scopus, CENTRAL, CT.gov, Cochrane report, PsycARTICLES, PsycINFO, and reference lists. This study included RCTs and observational studies of decision aids that measured prostate screening intention or behavior. The analysis was completed in April 2018. Evidence synthesis: Eighteen studies (13 RCTs, four before–after studies, and one non-RCT) reported data on screening intention for ≅8,400 men and screening uptake for 2,385 men. Compared with usual care, the use of decision aids in any format results in fewer men (aged ≥40 years) planning to undergo prostate-specific antigen testing (risk ratio=0.88, 95% CI=0.81, 0.95, p=0.006, I2=66%, p<0.001, n=8). Many men did not follow their screening intentions during the first year after using a decision aid; however, most men who were planning to undergo screening did so (probability that men who wanted to be screened would receive screening was 95%). Conclusions: Integration of decision aids in clinical practice may result in a decrease in the number of men who elect prostate-specific antigen testing, which may in turn reduce screening uptake. To ensure high congruence between intention and screening utilization, providers should not delay the shared decision-making discussion after patients use a decision aid.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Decision Support Techniques
Early Detection of Cancer
Meta-Analysis
Prostatic Neoplasms
Prostate-Specific Antigen
Decision Making
Information Storage and Retrieval
MEDLINE
Observational Studies
Prostate
Odds Ratio

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Prostate Cancer Screening Patient Decision Aids : A Systematic Review and Meta-analysis. / Ivlev, Ilya; Jerabkova, Silvie; Mishra, Meenakshi; Cook, Lily A.; Eden, Karen.

In: American Journal of Preventive Medicine, 01.01.2018.

Research output: Contribution to journalArticle

@article{b1c4dd9fa8c443eeb4c79e950f809652,
title = "Prostate Cancer Screening Patient Decision Aids: A Systematic Review and Meta-analysis",
abstract = "Context: Although screening recommendations for prostate cancer using prostate-specific antigen testing often include shared decision making, the effect of patient decision aids on patients’ intention and uptake is unclear. This study aimed to review the effect of decision aids on men's screening intention, screening utilization, and the congruence between intentions and uptake. Evidence acquisition: Data sources were searched through April 6, 2018, and included MEDLINE, Scopus, CENTRAL, CT.gov, Cochrane report, PsycARTICLES, PsycINFO, and reference lists. This study included RCTs and observational studies of decision aids that measured prostate screening intention or behavior. The analysis was completed in April 2018. Evidence synthesis: Eighteen studies (13 RCTs, four before–after studies, and one non-RCT) reported data on screening intention for ≅8,400 men and screening uptake for 2,385 men. Compared with usual care, the use of decision aids in any format results in fewer men (aged ≥40 years) planning to undergo prostate-specific antigen testing (risk ratio=0.88, 95{\%} CI=0.81, 0.95, p=0.006, I2=66{\%}, p<0.001, n=8). Many men did not follow their screening intentions during the first year after using a decision aid; however, most men who were planning to undergo screening did so (probability that men who wanted to be screened would receive screening was 95{\%}). Conclusions: Integration of decision aids in clinical practice may result in a decrease in the number of men who elect prostate-specific antigen testing, which may in turn reduce screening uptake. To ensure high congruence between intention and screening utilization, providers should not delay the shared decision-making discussion after patients use a decision aid.",
author = "Ilya Ivlev and Silvie Jerabkova and Meenakshi Mishra and Cook, {Lily A.} and Karen Eden",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.amepre.2018.06.016",
language = "English (US)",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Prostate Cancer Screening Patient Decision Aids

T2 - A Systematic Review and Meta-analysis

AU - Ivlev, Ilya

AU - Jerabkova, Silvie

AU - Mishra, Meenakshi

AU - Cook, Lily A.

AU - Eden, Karen

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Context: Although screening recommendations for prostate cancer using prostate-specific antigen testing often include shared decision making, the effect of patient decision aids on patients’ intention and uptake is unclear. This study aimed to review the effect of decision aids on men's screening intention, screening utilization, and the congruence between intentions and uptake. Evidence acquisition: Data sources were searched through April 6, 2018, and included MEDLINE, Scopus, CENTRAL, CT.gov, Cochrane report, PsycARTICLES, PsycINFO, and reference lists. This study included RCTs and observational studies of decision aids that measured prostate screening intention or behavior. The analysis was completed in April 2018. Evidence synthesis: Eighteen studies (13 RCTs, four before–after studies, and one non-RCT) reported data on screening intention for ≅8,400 men and screening uptake for 2,385 men. Compared with usual care, the use of decision aids in any format results in fewer men (aged ≥40 years) planning to undergo prostate-specific antigen testing (risk ratio=0.88, 95% CI=0.81, 0.95, p=0.006, I2=66%, p<0.001, n=8). Many men did not follow their screening intentions during the first year after using a decision aid; however, most men who were planning to undergo screening did so (probability that men who wanted to be screened would receive screening was 95%). Conclusions: Integration of decision aids in clinical practice may result in a decrease in the number of men who elect prostate-specific antigen testing, which may in turn reduce screening uptake. To ensure high congruence between intention and screening utilization, providers should not delay the shared decision-making discussion after patients use a decision aid.

AB - Context: Although screening recommendations for prostate cancer using prostate-specific antigen testing often include shared decision making, the effect of patient decision aids on patients’ intention and uptake is unclear. This study aimed to review the effect of decision aids on men's screening intention, screening utilization, and the congruence between intentions and uptake. Evidence acquisition: Data sources were searched through April 6, 2018, and included MEDLINE, Scopus, CENTRAL, CT.gov, Cochrane report, PsycARTICLES, PsycINFO, and reference lists. This study included RCTs and observational studies of decision aids that measured prostate screening intention or behavior. The analysis was completed in April 2018. Evidence synthesis: Eighteen studies (13 RCTs, four before–after studies, and one non-RCT) reported data on screening intention for ≅8,400 men and screening uptake for 2,385 men. Compared with usual care, the use of decision aids in any format results in fewer men (aged ≥40 years) planning to undergo prostate-specific antigen testing (risk ratio=0.88, 95% CI=0.81, 0.95, p=0.006, I2=66%, p<0.001, n=8). Many men did not follow their screening intentions during the first year after using a decision aid; however, most men who were planning to undergo screening did so (probability that men who wanted to be screened would receive screening was 95%). Conclusions: Integration of decision aids in clinical practice may result in a decrease in the number of men who elect prostate-specific antigen testing, which may in turn reduce screening uptake. To ensure high congruence between intention and screening utilization, providers should not delay the shared decision-making discussion after patients use a decision aid.

UR - http://www.scopus.com/inward/record.url?scp=85054845093&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054845093&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2018.06.016

DO - 10.1016/j.amepre.2018.06.016

M3 - Article

C2 - 30337235

AN - SCOPUS:85054845093

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

ER -