BMC Med Inform Decis Mak - A targeted decision aid for the elderly to decide whether to undergo colorectal cancer screening: development and results of an uncontrolled trial.

Tópicos

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Resumo

CKGROUND: Competing causes of mortality in the elderly decrease the potential net benefit from colorectal cancer screening and increase the likelihood of potential harms. Individualized decision making has been recommended, so that the elderly can decide whether or not to undergo colorectal cancer (CRC) screening. The objective is to develop and test a decision aid designed to promote individualized colorectal cancer screening decision making for adults age 75 and over.METHODS: We used formative research and cognitive testing to develop and refine the decision aid. We then tested the decision aid in an uncontrolled trial. The primary outcome was the proportion of patients who were prepared to make an individualized decision, defined a priori as having adequate knowledge (10/15 questions correct) and clear values (25 or less on values clarity subscale of decisional conflict scale). Secondary outcomes included overall score on the decisional conflict scale, and preferences for undergoing screening.RESULTS: We enrolled 46 adults in the trial. The decision aid increased the proportion of participants with adequate knowledge from 4% to 52% (p < 0.01) and the proportion prepared to make an individualized decision from 4% to 41% (p < 0.01). The proportion that preferred to undergo CRC screening decreased from 67% to 61% (p = 0. 76); 7 participants (15%) changed screening preference (5 against screening, 2 in favor of screening)CONCLUSION: In an uncontrolled trial, the elderly participants appeared better prepared to make an individualized decision about whether or not to undergo CRC screening after using the decision aid.

Resumo Limpo

ckground compet caus mortal elder decreas potenti net benefit colorect cancer screen increas likelihood potenti harm individu decis make recommend elder can decid whether undergo colorect cancer crc screen object develop test decis aid design promot individu colorect cancer screen decis make adult age overmethod use format research cognit test develop refin decis aid test decis aid uncontrol trial primari outcom proport patient prepar make individu decis defin priori adequ knowledg question correct clear valu less valu clariti subscal decision conflict scale secondari outcom includ overal score decision conflict scale prefer undergo screeningresult enrol adult trial decis aid increas proport particip adequ knowledg p proport prepar make individu decis p proport prefer undergo crc screen decreas p particip chang screen prefer screen favor screeningconclus uncontrol trial elder particip appear better prepar make individu decis whether undergo crc screen use decis aid

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