BMJ  2004;329:507-510 (28 August), doi:10.1136/bmj.329.7464.507

Education and debate

Use of decision aids to support informed choices about screening

¹ Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

Decisions about screening can be more complex than those about treatment. Well designed decision aids could help patients understand the risks as well as the benefits

The first 150 words of the full text of this article appear below.

Introduction

Patients should be able to participate in health decisions, if they so choose. Decision aids have been developed to help patients make informed decisions about treatment and have been found to improve knowledge, reduce indecision, and improve agreement between values and choice.¹ However, in screening, where informed choice is not common practice,² decision aids are controversial and their effect is currently unknown.^{3 4} Nevertheless, the complexities of decisions about screening mean that decision aids could be of immense value. In this paper we highlight eight issues that are critically important for the development and use of high quality decision aids about screening. Some of these issues arise because of fundamental differences between screening and treatment interventions; other issues flow from widespread uncritical support for screening, as illustrated by the storm over PSA (prostate specific antigen) screening for prostate cancer.^{5 6}

Problems with weighing the evidence

Weighing the evidence for and against a screening intervention is a complex . . . [Full text of this article]

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Developing and using decision aids for screening interventions

Conclusions

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This article has been cited by other articles:

• Howard, K., Barratt, A., Mann, G. J., Patel, M. I. (2009). A Model of Prostate-Specific Antigen Screening Outcomes for Low- to High-Risk Men: Information to Support Informed Choices. Arch Intern Med 169: 1603-1610 [Abstract] [Full text]  
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