TY - JOUR
T1 - Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening
T2 - A randomised controlled trial
AU - Pickles, Kristen
AU - Kazda, Luise
AU - Barratt, Alexandra
AU - McGeechan, Kevin
AU - Hersch, Jolyn
AU - McCaffery, Kirsten
N1 - Funding Information:
This study was co-funded by the Prostate Cancer Foundation of Australia (PCFA) and Wiser Healthcare. Wiser Healthcare is funded by the National Health and Medical Research Council (NHMRC) Program Grant 1113532. The funding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to acknowledge all the men who participated in the study, and extend thanks to Bruce Armstrong, Anthony Lowe, David Smith, Dragan Ilic, and Josh Beard graphic and web design for their valued contributions. We would particularly like to thank Associate Professor Mark Clements for providing quantitative estimates for prostate cancer mortality, metastatic cancer, overdiagnosed cancers, and false positive results, relevant to the Australian context.
Publisher Copyright:
© 2020 Pickles et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/1/15
Y1 - 2020/1/15
N2 - BACKGROUND: Australian clinicians are advised to 'offer evidence-based decisional support to men considering whether or not to have a PSA test'. This randomised trial compared the performance and acceptability of two new decision aids (DAs) to aid men in making informed choices about PSA screening.METHODS: ~3000 Australian men 45-60 years with varying educational attainment were recruited via an online panel and randomised to view one of two online decision aids (one full length, one abbreviated) and completed a questionnaire. The primary outcome was informed choice about PSA screening.FINDINGS: Significantly more men in the long DA group (38%) made an informed choice than men who received the shorter DA (33%) (95% CI 1.1% to 8.2%; p = 0.008). On knowledge, the long DA group scored, on average, 0.45 points higher than the short DA group (95% CI 0.14 to 0.76; p = 0.004) and 5% more of the participants achieved an adequate knowledge score (95% CI 1.9% to 8.8%; p = 0.002). Men allocated the long DA were less likely to intend to have a PSA test in the future (53%) than men in the short DA group (59%). Both DAs rated highly on acceptability.CONCLUSIONS: Both DAs were useful and acceptable to men regardless of education level and both supported informed decision making. The long version resulted in higher knowledge, and a higher proportion of men able to make an informed choice, but the differences were small. Long DAs may be useful for men whose informational needs are not satisfied by a short DA.
AB - BACKGROUND: Australian clinicians are advised to 'offer evidence-based decisional support to men considering whether or not to have a PSA test'. This randomised trial compared the performance and acceptability of two new decision aids (DAs) to aid men in making informed choices about PSA screening.METHODS: ~3000 Australian men 45-60 years with varying educational attainment were recruited via an online panel and randomised to view one of two online decision aids (one full length, one abbreviated) and completed a questionnaire. The primary outcome was informed choice about PSA screening.FINDINGS: Significantly more men in the long DA group (38%) made an informed choice than men who received the shorter DA (33%) (95% CI 1.1% to 8.2%; p = 0.008). On knowledge, the long DA group scored, on average, 0.45 points higher than the short DA group (95% CI 0.14 to 0.76; p = 0.004) and 5% more of the participants achieved an adequate knowledge score (95% CI 1.9% to 8.8%; p = 0.002). Men allocated the long DA were less likely to intend to have a PSA test in the future (53%) than men in the short DA group (59%). Both DAs rated highly on acceptability.CONCLUSIONS: Both DAs were useful and acceptable to men regardless of education level and both supported informed decision making. The long version resulted in higher knowledge, and a higher proportion of men able to make an informed choice, but the differences were small. Long DAs may be useful for men whose informational needs are not satisfied by a short DA.
KW - Australia/epidemiology
KW - Decision Making
KW - Decision Support Techniques
KW - Early Detection of Cancer
KW - Humans
KW - Male
KW - Middle Aged
KW - Prostate-Specific Antigen/blood
KW - Prostatic Neoplasms/diagnosis
KW - Psychometrics
KW - Surveys and Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85077940886&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0227304
DO - 10.1371/journal.pone.0227304
M3 - Article
C2 - 31940376
SN - 1932-6203
VL - 15
SP - 1
EP - 15
JO - PLoS One
JF - PLoS One
IS - 1
M1 - e0227304
ER -
