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The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening

Author

Listed:
  • Paul C. Schroy III
  • Karen Emmons
  • Ellen Peters
  • Julie T. Glick
  • Patricia A. Robinson
  • Maria A. Lydotes
  • Shamini Mylvanaman
  • Stephen Evans
  • Christine Chaisson
  • Michael Pignone
  • Marianne Prout
  • Peter Davidson
  • Timothy C. Heeren

Abstract

Background. Eliciting patients’ preferences within a framework of shared decision making (SDM) has been advocated as a strategy for increasing colorectal cancer (CRC) screening adherence. Our objective was to assess the effectiveness of a novel decision aid on SDM in the primary care setting. Methods. An interactive, computer-based decision aid for CRC screening was developed and evaluated within the context of a randomized controlled trial. A total of 665 average-risk patients (mean age, 57 years; 60% female; 63% black, 6% Hispanic) were allocated to 1 of 2 intervention arms (decision aid alone, decision aid plus personalized risk assessment) or a control arm. The interventions were delivered just prior to a scheduled primary care visit. Outcome measures (patient preferences, knowledge, satisfaction with the decision-making process [SDMP], concordance between patient preference and test ordered, and intentions) were evaluated using prestudy/poststudy visit questionnaires and electronic scheduling. Results. Overall, 95% of patients in the intervention arms identified a preferred screening option based on values placed on individual test features. Mean cumulative knowledge, SDMP, and intention scores were significantly higher for both intervention groups compared with the control group. Concordance between patient preference and test ordered was 59%. Patients who preferred colonoscopy were more likely to have a test ordered than those who preferred an alternative option (83% v. 70%; P

Suggested Citation

  • Paul C. Schroy III & Karen Emmons & Ellen Peters & Julie T. Glick & Patricia A. Robinson & Maria A. Lydotes & Shamini Mylvanaman & Stephen Evans & Christine Chaisson & Michael Pignone & Marianne Prout, 2011. "The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening," Medical Decision Making, , vol. 31(1), pages 93-107, January.
    • Handle: RePEc:sae:medema:v:31:y:2011:i:1:p:93-107
    DOI: 10.1177/0272989X10369007
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    References listed on IDEAS

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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Wolf, R.L. & Basch, C.E. & Brouse, C.H. & Shmukler, C. & Shea, S., 2006. "Patient preferences and adherence to colorectal cancer screening in an urban population," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 809-811.
    3. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
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    1. Danielle M. Muscat & Jenna Smith & Olivia Mac & Tamara Cadet & Anik Giguere & Ashley J. Housten & Aisha T. Langford & Sian K. Smith & Marie-Anne Durand & Kirsten McCaffery, 2021. "Addressing Health Literacy in Patient Decision Aids: An Update from the International Patient Decision Aid Standards," Medical Decision Making, , vol. 41(7), pages 848-869, October.
    2. Sergey Motorny & Surendra Sarnikar & Cherie Noteboom, 2022. "Design of an Intelligent Patient Decision aid Based on Individual Decision-Making Styles and Information Need Preferences," Information Systems Frontiers, Springer, vol. 24(4), pages 1249-1264, August.

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