title: Use of a web-based survey to facilitate shared decision making for patients eligible for cancer screening.
abstract: OBJECTIVE
  Our aim was to facilitate shared decision making (SDM) during preventive visits by utilizing a web-based survey system to offer colorectal cancer (CRC) and prostate cancer screening decision aids (DAs) to appropriately identified patients prior to the visit.
  
  
  METHODS
  Patients completed a web-based questionnaire before their preventive medicine appointment. Age- and gender-appropriate patients completed additional questions to determine eligibility for CRC or prostate-specific antigen (PSA) screening. Eligible patients were offered a choice of video or print DA, and completed questions assessing their knowledge, values, and preferences regarding the screening decision. Responses were summarized and fed forward to clinician and patient reports.
  
  
  RESULTS
  Overall, 11,493 CRC and 4,384 PSA questionnaires were completed. Patient responses were used to identify those eligible for cancer-screening DAs: 2,187 (19 %) for CRC and 2,962 (68 %) for PSA; 15 % of eligible patients requested a DA. Many patients declined a DA because they indicated they "already know enough to make their decision" (34 % for CRC, 46 % for PSA).
  
  
  CONCLUSIONS
  A web-based questionnaire provides an efficient means to identify patients eligible for cancer screening decisions and to offer them DAs before an appointment. Pre-visit use of DAs along with reports giving feedback to patients and clinicians provides an opportunity for SDM to occur at the visit.
authors.affiliation: Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA, cdb@hitchcock.org.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Brackett
authors.forename: Stephen
authors.initials: S
authors.lastname: Kearing
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003657:Decision Making; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods*; D011320:Primary Health Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis*
chemical_list: D017430:Prostate-Specific Antigen