Mara A. Schonberg|Mary Beth Hamel|Roger B. Davis|Miriam Griggs|Christina C. Wee|Angela Fagerlin|Edward R. Marcantonio
Development and Evaluation of a Decision Aid on Mammography Screening for Women 75 Years and Older
Beth Israel Deaconess Medical Center|Harvard University|Beth Israel Deaconess Medical Center|Harvard University|Beth Israel Deaconess Medical Center|Harvard University|Beth Israel Deaconess Medical Center|Harvard University|Beth Israel Deaconess Medical Center|Harvard University|VA Center for Clinical Management Research|University of Michigan–Ann Arbor|Beth Israel Deaconess Medical Center|Harvard University
h3importanceh3 guidelines recommend women 75 years older informed benefits risks mammography screened however adequately informed h3objectivesh3 develop evaluate mammography screening decision aid da women 75 years older h3designh3 designed da using international standards july 14 2010 april 10 2012 participants completed pretest survey read da appointment primary care physician completed posttest survey appointment medical records reviewed followup information h3setting participantsh3 boston massachusetts academic primary care practice eligible women aged 75 89 years english speaking mammogram 9 months screened within past 3 years history dementia invasive noninvasive breast cancer 84 women approached 27 declined participate 12 unable complete study logistical reasons 45 participated h3interventionsh3 da includes information breast cancer risk life expectancy competing mortality risks possible outcomes screening values clarification exercise h3main outcomes measuresh3 knowledge benefits risks screening decisional conflict screening intentions documentation medical record discussion risks benefits mammography primary care physician within 6 months receipt screening within 15 months used wilcoxon signed rank test mcnemar test compare pretestposttest information h3resultsh3 median age participants 79 years 69 31 45 nonhispanic white raceethnicity 60 27 45 attended least college comparison posttest results pretest results demonstrated 2 findings first knowledge benefits risks screening improved ipi lt 001 second fewer participants intended screened 56 25 45 afterward compared 82 37 45 beforeipi 03 decisional conflict declined significantly ipi 10 following 6 months 53 24 45 participants primary care physician note documented discussion risks benefits screening compared 11 5 45 previous 5 years ipi lt 001 84 36 43 screened within 2 years participating 60 26 43 screened within 15 months participating 2 years since last mammogram ipi 01 overall 93 42 45 found da helpful h3conclusions relevanceh3 da may improve older womens decision making mammography screening