Randomized controlled trial of a patient decision aid for colorectal cancer screening.
OBJECTIVE
To conduct a pilot test of a decision aid designed to help patients choose among currently recommended colorectal cancer screening programs.


METHODS
Randomized controlled trial comparing a patient decision aid based on multicriteria decision-making theory with a simple educational intervention.


METHODS
96 patients at average risk for colorectal cancer seen in an Internal Medicine practice in Rochester, New York.


METHODS
The two primary outcome measures were patient decision process and the decision outcome. Patient decision process was assessed using the decisional conflict scale. Decision outcome was defined as the proportion of colorectal cancer screening plans carried out.


RESULTS
After controlling for the effects of the physicians in a factorial analysis of variance, patients who used the decision aid had lower decisional conflict regarding colorectal cancer screening decisions (F ratio 6.47, P = 0.01) due to increased knowledge, better clarity of values, and higher ratings of the quality of the decisions they made. There was no difference between the groups in decision outcomes: 52% of patients in the control group and 49% in the experimental group completed planned screening tests (P = 1.0).


CONCLUSIONS
In a pilot study, a multicriteria-based patient decision aid for colorectal cancer screening improved patients' decision-making processes but had no effect on the implementation of screening plans.
Dolan
James G
JG
Department of Medicine, University of Rochester, Unity Health System, New York 14626, USA. jdolan@unityhealth.org
Frisina
Susan
S
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D010865:Pilot Projects