Intended for healthcare professionals


Decision aids and uptake of screening

BMJ 2010; 341 doi: (Published 26 October 2010) Cite this as: BMJ 2010;341:c5407
  1. Hilary L Bekker, senior lecturer in behavioural sciences
  1. 1Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds LS2 9LJ, UK
  1. h.l.bekker{at}

Aids improve informed decision making, but not necessarily uptake

Two linked papers assessed patient information in the prevention of bowel cancer: Kirkegaard and colleagues (doi:10.1136/bmj.c5504) encouraged adherence with lifestyle recommendations,1 and Smith and colleagues (doi:10.1136/bmj.c5370) facilitated informed screening choices.2 Smith and colleagues’ study evaluated a decision aid to inform adults’ choices about faecal occult blood testing. The results raise the possibility that uncritical acceptance of informed choice initiatives may cause more harm than good.

Decision aids help people decide between two or more options. They are based on evidence from the decision sciences on how judgments and decisions are altered when facts are presented in different ways. Decision aids include several components that limit the influence that the style of presentation has on judgments and choices, encourage people to attend to the pertinent facts, encourage people to think explicitly about the facts and how they fit with their existing beliefs, and help them use these evaluations to reach a decision.3

Decision aids help patients clarify why the treatment or test option they choose is better for them than the …

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