title: Shared decision making in patients at risk of cancer: the role of domain and numeracy.
abstract: BACKGROUND
  Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy.
  
  
  OBJECTIVE
  To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities.
  
  
  METHODS
  Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales.
  
  
  RESULTS
  Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer.
  
  
  CONCLUSIONS
  Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer.
  
  
  CONCLUSIONS
  Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills.
authors.affiliation: School of Psychology, Cognition Institute, University of Plymouth, Drake Circus, Plymouth, UK.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Hanoch
authors.affiliation: Center for Medical Decision Making, Ono Academic College, Kiryat Ono, Israel.
authors.forename: Talya
authors.initials: T
authors.lastname: Miron-Shatz
authors.affiliation: School of Psychology, Queen's University Belfast, Belfast, UK.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Rolison
authors.affiliation: Massachusetts General Hospital-Institute for Technology Assessment, Boston, MA, USA.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Omer
authors.affiliation: The Dartmouth Institute Geisel School of Medicine at Dartmouth, Centerra Parkway, Lebanon, NH, USA.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ozanne
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000209:etiology / Q000235:genetics / Q000523:psychology; D003657:Decision Making; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000235:genetics / Q000523:psychology*; D057240:Patient Preference; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: cancer; objective numeracy and subjective numeracy; shared decision making