Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial

Reder M, Kolip P (2017)
PLOS ONE 12(12): e0189148.

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Journal Article | Original Article | Published | English
Abstract
Background Decision aids can support informed choice in mammography screening, but for the German mammography screening programme no systematically evaluated decision aid exists to date. We developed a decision aid for women invited to this programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. Objective To determine whether a decision aid increases informed choice about mammography screening programme participation. Methods A representative sample of 7,400 women aged 50 was drawn from registration offices in Westphalia-Lippe, Germany. Women were randomised to receive usual care (i.e., the standard information brochure sent with the programme’s invitation letter) or the decision aid. Data were collected online at baseline, post-intervention, and 3 months follow-up. The primary outcome was informed choice. Secondary outcomes were the constituents of informed choice (knowledge, attitude, intention/uptake), decisional conflict, decision regret, and decision stage. Outcomes were analysed using latent structural equation models and χ2-tests. Results 1,206 women participated (response rate of 16.3%). The decision aid increased informed choice. Women in the control group had lower odds to make an informed choice at post-intervention (OR 0.26, 95% CI 0.18-0.37) and at follow-up (OR 0.66, 95% CI 0.46-0.94); informed choices remained constant at 30%. This was also reflected in lower knowledge and more decisional conflict. Post-intervention, the uptake intention was higher in the control group, whereas the uptake rate at follow-up was similar. Women in the control group had a more positive attitude at follow-up than women receiving the decision aid. Decision regret and decision stage were not influenced by the intervention. Conclusion This paper describes the first systematic evaluation of a newly developed decision aid for the German mammography screening programme in a randomised controlled trial. Our decision aid proved to be an effective tool to enhance the rate of informed choice and was made accessible to the public.
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Article Processing Charge funded by the Deutsche Forschungsgemeinschaft and the Open Access Publication Fund of Bielefeld University.
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Reder M, Kolip P. Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE. 2017;12(12): e0189148.
Reder, M., & Kolip, P. (2017). Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE, 12(12), e0189148. doi:10.1371/journal.pone.0189148
Reder, M., and Kolip, P. (2017). Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE 12:e0189148.
Reder, M., & Kolip, P., 2017. Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE, 12(12): e0189148.
M. Reder and P. Kolip, “Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial”, PLOS ONE, vol. 12, 2017, : e0189148.
Reder, M., Kolip, P.: Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE. 12, : e0189148 (2017).
Reder, Maren, and Kolip, Petra. “Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial”. PLOS ONE 12.12 (2017): e0189148.
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