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. 2025 Feb;135(2):222-234.
doi: 10.1111/bju.16545. Epub 2024 Oct 14.

Efficacy of decision aid delivery modes in prostate cancer screening: umbrella review and network meta-analysis

Zen Yang Ang  1   2 , Yuke-Lin Kong  1 , Zarith Nameyrra Md Nesran  1 , Shaun Wen Huey Lee  2
Affiliations

Efficacy of decision aid delivery modes in prostate cancer screening: umbrella review and network meta-analysis

Zen Yang Ang et al. BJU Int. 2025 Feb.

Abstract

Objective: To review and compare the efficacy of different delivery modes of decision aids (DAs), including computer-based, print-based, multimedia-based, video-based, and website-based on decision-making outcomes for prostate cancer screening compared to usual care (UC) and among the delivery modes.

Methods: PubMed, the Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Advanced Search, and Turning Research Into Practice (TRIP) Database were systematically searched from inception to August 2023. The primary outcomes were knowledge level, knowledge scores, participation in shared decision-making (SDM), decisional conflict, and preference for SDM participation. Secondary outcomes were the proportion of subjects who underwent screening (actual screening utilisation) and the proportion of subjects who intended to be screened (intention to undergo screening). Network and pairwise meta-analyses were performed using random-effects models.

Results: Seven systematic reviews were included. Network meta-analysis found that multimedia (relative risk [RR] 1.51, 95% confidence interval [CI] 1.02-2.24), print (RR 1.82, 95% CI 1.23-2.69), and website-based (RR 1.99, 95% CI 1.32-3.01) DAs significantly increased participation in SDM compared to the computer-based DA. There was a significant reduction in the actual screening utilisation in the computer DA arm compared to the other delivery modes. No significant differences between all delivery modes were noted on knowledge levels, knowledge scores, decisional conflict, preference for SDM participation, and intention to undergo screening. The highest mean surface under the cumulative ranking curve for all primary outcomes showed that website-based was the most effective delivery mode, followed by print-based DA. The pairwise meta-analysis showed a significant increase in participants' knowledge level, knowledge scores, a reduced intention to undergo screening and actual screening utilisation compared to UC.

Conclusions: The findings suggest that different types of DAs have varying levels of effectiveness in increasing knowledge level, knowledge scores, participation in SDM, and influencing screening behaviours. While website-based DA appeared the most effective, employing the print-based DA could be a practical solution in settings with limited resources.

Keywords: decision aid; decision support techniques; prostate cancer; prostate‐specific antigen; screening.

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Figures

Fig. 1
Fig. 1
The PRISMA flow diagram for the scoping review and Phase 1.
See this image and copyright information in PMC

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References

    1. Sung H, Ferlay J, Siegel RL et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209–249 - PubMed
    1. Kocarnik JM, Compton K, Dean FE et al. Cancer incidence, mortality, years of life lost, years lived with disability, and disability‐adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the global burden of disease study 2019. JAMA Oncologia 2022; 8: 420–444 - PMC - PubMed
    1. Ito K, Oki R, Sekine Y et al. Screening for prostate cancer: history, evidence, controversies and future perspectives toward individualized screening. Int J Urol 2019; 26: 956–970 - PubMed
    1. United States Preventive Services Task Force . Final Recommendation Statement – Prostate Cancer: Screening. Maryland: United States Preventive Services Task Force, 2018.
    1. Cornford P, van den Bergh RCN, Briers E et al. EAU‐EANM‐ESTRO‐ESUR‐ISUP‐SIOG Guidelines on Prostate Cancer‐2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent. Switzerland: European Association of Urology, 2024. - PubMed

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