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The Article in Brief
Persuasive Interventions for Controversial Cancer Screening Recommendations: Testing a Novel Approach to Help Patients Make Evidence-Based Decisions
Barry G. Saver , and colleagues
Background Patients face many medical decisions. Decisions are, however, shaped by a variety of human and social factors, and evidence for decision-making is often complicated and incomplete. This study tests novel video decision aids designed to help patients trust and accept controversial U.S. Preventive Services Task Force recommendations, a) against screening for prostate cancers with the prostate specific antigen test and b) that women in their 40s should make an informed choice about mammography.
What This Study Found While a more traditional, print decision aid had no effect on participants' screening intentions, recorded video vignettes of physician-patient discussions about the recommendations significantly changed the screening intentions of a substantial proportion of participants. At entry, 86 percent of the 35 women in the study reported wanting screening, 6 percent were unsure, and 9 percent did not want screening. At the study end, 49 percent of the women wanted screening, 20 percent were unsure, and 29 percent did not want screening. At entry, 69 percent of the 27 men who participated in the study reported wanting prostate screening, and 31 percent were unsure. After exposure to both interventions, 33 percent wanted screening, 11 percent were unsure, and 56 percent did not want screening.
Implications
- The authors note while this novel, persuasive video approach needs further testing, the findings are far more promising than those previously reported for many other decision aids. This approach may serve as a model for persuasive interventions for helping patients consider and accept evidence-based, counterintuitive recommendations and reduce use of low-value procedures.