Identifying best practices for disclosure of amyloid imaging results: A randomized controlled trial

Abstract

Introduction: Empirical studies on effective communication for amyloid disclosure in mild cognitive impairment (MCI) are lacking. We aimed to study the impact of six communication strategies.

Method: We performed a randomized controlled trial with seven randomly assigned, video-vignette conditions: six emphasizing a communication strategy and one basic condition. All showed a scripted consultation of a neurologist disclosing positive amyloid positron emission tomography (PET) scan results to an MCI patient. Healthy individuals (N = 1017; mean age ± SD 64 ± 8, 808 (79%) female) were instructed to imagine themselves in the video, answered questionnaires assessing information recall, emotional state, and behavioral intentions, and evaluate the physician/information.

Results: "Risk best practice" resulted in highest free recall compared to other strategies (P < .05), except "emotional support". Recall in "emotional support" was better compared to "basic-' and elaborate information"(P < .05). "Risk best practice" resulted in the highest uncertainty (P < .001). "Teach-back" and "emotional support" contributed to the highest evaluations (P -values < .01).

Conclusion: Risk communication best practices, attending to emotions, and teach-back techniques enhance information recall of amyloid-PET results, and could contribute to positive care evaluations.

Keywords: MCI; amyloid status; communication; disclosure; mild cognitive impairment.

FIGURE 1

Schematic overview of study measures

FIGURE 2

Boxplots present significant differences between communication strategies on free information recall, and information recognition. Analyses of variance (ANOVAs) showed an effect of condition on both free information recall and information recognition. Post hoc Bonferroni adjusted comparisons between conditions showed highest free information recall in the risk‐best practice condition, and highest information recognition in the emotional support condition. * P < .05, ** P < .01, P < .001

FIGURE 3

Boxplots present significant differences between communication strategies on outcome measures uncertainty, trust, satisfaction with physician, and information satisfaction. Analysis of variance (ANOVA) showed an effect of conditions for uncertainty, trust in the physician, satisfaction with the physician, and satisfaction with the information. Post hoc Bonferroni adjusted comparisons between conditions showed highest uncertainty in the risk‐best practice condition, highest trust in‐ and satisfaction with the physician, and the information in the teach‐back condition. * P < .05, ** P < .01, P < .001