Risk Stratification and Shared Decision Making for Colorectal Cancer Screening: A Randomized Controlled Trial

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Paul C SchroyJohn B Wong

Abstract

Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer (CRC) screening, yet providers often fail to comply with patient preferences that differ from their own. To determine whether risk stratification for advanced colorectal neoplasia (ACN) influences provider willingness to comply with patient preferences when selecting a desired CRC screening option. Randomized controlled trial. Asymptomatic, average-risk patients due for CRC screening in an urban safety net health care setting. Patients were randomized 1:1 to a decision aid alone (n= 168) or decision aid plus risk assessment (n= 173) arm between September 2012 and September 2014. The primary outcome was concordance between patient preference and test ordered; secondary outcomes included patient satisfaction with the decision-making process, screening intentions, test completion rates, and provider satisfaction. Although providers perceived risk stratification to be useful in selecting an appropriate screening test for their average-risk patients, no significant differences in concordance were observed between the decision aid alone and decision aid plus risk assessment groups (88.1% v. 85.0%,P= 0.40) or high- and l...Continue Reading

References

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Citations

Jul 20, 2018·The Cochrane Database of Systematic Reviews·France LégaréNorbert Donner-Banzhoff
Mar 7, 2018·Menopause : the Journal of the North American Menopause Society·Sharon J ParishSheryl Kingsberg
Feb 18, 2017·World Journal of Gastroenterology : WJG·Mark PrinceBarry Berger
Jan 12, 2019·BMC Medical Informatics and Decision Making·Lilisbeth Perestelo-PerezPedro Serrano-Aguilar
Dec 10, 2019·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Shannon M ChristyVictoria L Champion

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