Screening decisions can be more complex than treatment decisions, well-designed decision-making aid could help patients understand the risks and benefits
Patients should be able to participate in health decisions, decision-making aids have been developed to help patients make informed decisions on treatment and to improve knowledge if they so wish and for these reasons.
However, in screening, where informed choice is not a common practice, decision-making aids are controversial and their effect is currently unknown.
A Finnish team analyzed 19 randomised controlled studies that compared DA’s for prostate cancer screening with the usual therapy. They found out the DA’s are:
- Probably associated with the improvement of knowledge (evidence of low quality).
- Probably associated with a small decrease in decision conflict (evidence of moderate quality).
- Probably not associated with doctors and patients discussing prostate cancer screening (low quality evidence) or with men’s decision to undergo prostate cancer screening (low quality test).
Note that randomised and controlled studies of prostate cancer screening das compared to usual treatments are heterogeneous in DA content, design, delivery and results.
Looking to the future, it should include the possibility of continuous updating of new evidence and not only provide education for patients, but also promote a shared decision-making process in the doctor-patient meeting.