Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening: A randomised controlled trial

PLoS One. 2020 Jan 15;15(1):e0227304. doi: 10.1371/journal.pone.0227304. eCollection 2020.

Abstract

Background: Australian clinicians are advised to 'offer evidence-based decisional support to men considering whether or not to have a PSA test'. This randomised trial compared the performance and acceptability of two new decision aids (DAs) to aid men in making informed choices about PSA screening.

Methods: ~3000 Australian men 45-60 years with varying educational attainment were recruited via an online panel and randomised to view one of two online decision aids (one full length, one abbreviated) and completed a questionnaire. The primary outcome was informed choice about PSA screening.

Findings: Significantly more men in the long DA group (38%) made an informed choice than men who received the shorter DA (33%) (95% CI 1.1% to 8.2%; p = 0.008). On knowledge, the long DA group scored, on average, 0.45 points higher than the short DA group (95% CI 0.14 to 0.76; p = 0.004) and 5% more of the participants achieved an adequate knowledge score (95% CI 1.9% to 8.8%; p = 0.002). Men allocated the long DA were less likely to intend to have a PSA test in the future (53%) than men in the short DA group (59%). Both DAs rated highly on acceptability.

Conclusions: Both DAs were useful and acceptable to men regardless of education level and both supported informed decision making. The long version resulted in higher knowledge, and a higher proportion of men able to make an informed choice, but the differences were small. Long DAs may be useful for men whose informational needs are not satisfied by a short DA.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia / epidemiology
  • Decision Making
  • Decision Support Techniques
  • Early Detection of Cancer*
  • Humans
  • Male
  • Middle Aged
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology*
  • Prostatic Neoplasms / psychology*
  • Psychometrics*
  • Surveys and Questionnaires

Substances

  • Prostate-Specific Antigen

Grants and funding

This study was co-funded by the Prostate Cancer Foundation of Australia (PCFA) and Wiser Healthcare. Wiser Healthcare is funded by the National Health and Medical Research Council (NHMRC) Program Grant 1113532. The funding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.