Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Nov 13:12:130.
doi: 10.1186/1472-6947-12-130.

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

Stacey L Sheridan  1 , Carol Golin, Audrina Bunton, John B Lykes, Bob Schwartz, Lauren McCormack, David Driscoll, Shrikant I Bangdiwala, Russell P Harris
Affiliations
Randomized Controlled Trial

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

Stacey L Sheridan et al. BMC Med Inform Decis Mak. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Recruitment and Enrollment.
See this image and copyright information in PMC

References

    1. Schroeder F, Hugosson J, Roobol M, Tammela T, Ciatto S, Nelen V, Kwiatkowsi M, Lujan M, Lilja H, Zappa M. et al.Screening and prostate-cancer mortality in a randomized european study. N Engl J Med. 2009;360:1320–1328. doi: 10.1056/NEJMoa0810084. - DOI - PubMed
    1. Andriole G, Crawford E, Grubb R, Buys S, Chia D, Church T, Fouad M, Gelmnann E, Kvale P, Reding D. et al.Mortality results from a randomized prostate-cancer screening trial. N Engl J Med. 2009;360:1310–1319. doi: 10.1056/NEJMoa0810696. - DOI - PMC - PubMed
    1. Moyer VA. Screening for prostate cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2012;157(2):120–134. - PubMed
    1. Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? JAMA. 2003;289(11):1414–1420. doi: 10.1001/jama.289.11.1414. - DOI - PubMed
    1. Thorndike AN, Regan S, Rigotti NA. The treatment of smoking by US physicians during ambulatory visits: 1994 2003. Am J Public Health. 2007;97(10):1878–1883. doi: 10.2105/AJPH.2006.092577. - DOI - PMC - PubMed

Publication types

Substances

Associated data