Paul C. Schroy|Karen M. Emmons|Ellen Peters|Julie T. Glick|Patricia A. Robinson|Maria A. Lydotes|Shamini Mylvaganam|Alison Coe|Clara A. Chen|Christine E. Chaisson|Michael Pignone|Marianne N. Prout|Peter Davidson|Timothy Heeren
Aid-Assisted Decision Making and Colorectal Cancer Screening
Boston University|Dana-Farber Cancer Institute|The Ohio State University|Boston University|Boston University|Boston University|Boston University|Boston University|Boston University|Boston University|University of North Carolina at Chapel Hill|Boston University|Boston University|Boston University
backgroundshared decision making sdm widely recommended yet unproven strategy increasing colorectal cancer crc screening uptake previous trials decision aids increase sdm crc screening uptake yielded mixed resultspurposeto assess impact decision aidassisted sdm crc screening uptakedesignrctsettingparticipantsthe study conducted urban academic safetynet hospital community health center 2005 2010 participants asymptomatic averagerisk patients aged 5075 years due crc screeninginterventionstudy participants n825 randomized one two intervention arms decision aid plus personalized risk assessment decision aid alone control arm interventions took place prior routine office visit primary care providersmain outcome measuresthe primary outcome completion crc screening test within 12 months study visit logistic regression used identify predictors test completion mediators intervention effect analysis completed 2011resultspatients decisionaid group likely complete screening test control patients 431 vs 348 p0046 within 12 months study visit conversely test uptake decision aid decision aid plus personalized risk assessment arms similar 431 vs 371 p015 assignment decisionaid arm aor148 95 ci104 210 black race aor152 95 ci112 206 preference patientdominant decisionmaking approach aor155 95 ci102 235 independent determinants test completion activation screening discussion enhanced screening intentions mediated intervention effectconclusionsdecision aidassisted sdm modest impact crc screening uptake decision aid plus personalized risk assessment tool effective decision aid alonetrial registrationthis study registered wwwclinicaltrialsgov nct00251862 shared decision making sdm widely recommended yet unproven strategy increasing colorectal cancer crc screening uptake previous trials decision aids increase sdm crc screening uptake yielded mixed results assess impact decision aidassisted sdm crc screening uptake rct study conducted urban academic safetynet hospital community health center 2005 2010 participants asymptomatic averagerisk patients aged 5075 years due crc screening study participants n825 randomized one two intervention arms decision aid plus personalized risk assessment decision aid alone control arm interventions took place prior routine office visit primary care providers primary outcome completion crc screening test within 12 months study visit logistic regression used identify predictors test completion mediators intervention effect analysis completed 2011 patients decisionaid group likely complete screening test control patients 431 vs 348 p0046 within 12 months study visit conversely test uptake decision aid decision aid plus personalized risk assessment arms similar 431 vs 371 p015 assignment decisionaid arm aor148 95 ci104 210 black race aor152 95 ci112 206 preference patientdominant decisionmaking approach aor155 95 ci102 235 independent determinants test completion activation screening discussion enhanced screening intentions mediated intervention effect decision aidassisted sdm modest impact crc screening uptake decision aid plus personalized risk assessment tool effective decision aid alone