title: Deliberative democracy and cancer screening consent: a randomised control trial of the effect of a community jury on men's knowledge about and intentions to participate in PSA screening.
abstract: OBJECTIVE
  Prostate-specific antigen (PSA) screening is controversial. A community jury allows presentation of complex information and may clarify how participants view screening after being well-informed. We examined whether participating in a community jury had an effect on men's knowledge about and their intention to participate in PSA screening.
  
  
  METHODS
  Random allocation to either a 2-day community jury or a control group, with preassessment, postassessment and 3-month follow-up assessment.
  
  
  METHODS
  Participants from the Gold Coast (Australia) recruited via radio, newspaper and community meetings.
  
  
  METHODS
  Twenty-six men aged 50-70 years with no previous diagnosis of prostate cancer.
  
  
  METHODS
  The control group (n=14) received factsheets on PSA screening. Community jury participants (n=12) received the same factsheets and further information about screening for prostate cancer. In addition, three experts presented information on PSA screening: a neutral scientific advisor provided background information, one expert emphasised the potential benefits of screening and another expert emphasised the potential harms. Participants discussed information, asked questions to the experts and deliberated on personal and policy decisions.
  
  
  METHODS
  Our primary outcome was change in individual intention to have a PSA screening test. We also assessed knowledge about screening for prostate cancer.
  
  
  RESULTS
  Analyses were conducted using intention-to-treat. Immediately after the jury, the community jury group had less intention-to-screen for prostate cancer than men in the control group (effect size=-0.6 SD, p=0.05). This was sustained at 3-month follow-up. Community jury men also correctly identified PSA test accuracy and considered themselves more informed (effect size=1.2 SD, p<0.001).
  
  
  CONCLUSIONS
  Evidence-informed deliberation of the harms and benefits of PSA screening effects men's individual choice to be screened for prostate cancer. Community juries may be a valid method for eliciting target group input to policy decisions.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registry (ACTRN12612001079831).
authors.affiliation: Faculty of Health Sciences and Medicine, Centre for Research in Evidence-Based Practice (CREBP), Bond University, Gold Coast, Queensland, Australia.
authors.forename: Rae
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Faculty of Health Sciences and Medicine, Centre for Research in Evidence-Based Practice (CREBP), Bond University, Gold Coast, Queensland, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Glasziou
authors.affiliation: School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lucie
authors.initials: L
authors.lastname: Rychetnik
authors.affiliation: Faculty of Law, Bond University, Gold Coast, Queensland, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Mackenzie
authors.affiliation: Department of Urology, University of Queensland Centre for Clinical Research, Royal Brisbane & Women's Hospital, Gold Coast, Queensland, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Gardiner
authors.affiliation: Faculty of Health Sciences and Medicine, Centre for Research in Evidence-Based Practice (CREBP), Bond University, Gold Coast, Queensland, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Doust
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D003256:Community Participation / Q000331:legislation & jurisprudence; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D033182:Intention; D033222:Judicial Role; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D020458:Third-Party Consent / Q000331:legislation & jurisprudence*; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen
keywords: PRIMARY CARE; PUBLIC HEALTH; Prostate Cancer; Prostate Specific Antigen testing