Decision aids for prostate cancer screening choice: A systematic review and meta-analysis

Riikonen, Jarno; Guyatt, Gordon; Kilpeläinen, Tuomas P.; Craigie, Samantha; Agarwal, Arnav; Agoritsas, Thomas; Couban, Rachel; Dahm, Philipp; Järvinen, Petrus; Montori, Víctor M.; Power, Nicholas; Richard, Patrick O.; Rutanen, Juha; Santti, Henrikki; Tailly, Thomas; Violette, Philippe D.; Zhou, Qi; Tikkinen, Kari A.O.

doi:10.1016/s1569-9056(18)31118-7

Cited by 23 publications

(34 citation statements)

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“…Hälleberg-Nyman et al [16] in qualitative study reported patient-reported satisfaction scores to be better in patients receiving radiotherapy, when clinical consults were supplemented with the interactive app, Interaktor, corroborating the aforementioned view. In prostate cancer, SDM with DAs is particularly pertinent, due to controversies in areas such as prostate cancer screening and the availability of plethora of therapeutic options [31]. In this review, a number of PCAs addressed the subject of PSA screening and reassuringly most PCAs had a neutral tone for PSA screening.…”

Section: Individual Applications Includes Studies Evaluated By the Aumentioning

confidence: 97%

Do prostate cancer-related mobile phone apps have a role in contemporary prostate cancer management? A systematic review by EAU young academic urologists (YAU) urotechnology group

et al. 2020

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Aims and objectives To review the available literature regarding the use of prostate cancer-related mobile phone applications (PCA). Materials and methods The search was for English language articles between inceptions of databases to June 2019. Medline, EMBASE, Cochrane Library, CINAHL and Web of Science were searched. Full-text articles were reviewed, and the following data were extracted to aid with app analysis: name of application, developer, platform (Apple App Store or Google Play Store) and factors assessed by the article. Results The search yielded 1825 results of which 13 studies were included in the final review. 44 PCAs were identified from the data collected of which 59% of the PCAs had an educational focus. 11 apps were inactive and 5 weren’t updated within the last year. Five studies focused on the development and testing of apps (MyHealthAvatar, CPC, Rotterdam, Interaktor, NED). Two studies evaluated the readability of PCAs. Most PCAs had a reading level greater than that of the average patient. Two studies evaluated the quality and accuracy of apps. Majority of PCAs were accurate with a wide range of information. The study reported most PCAs to have deficient or insufficient scores for data protection. Two studies evaluated the accuracy of Rotterdam, CORAL and CPC risk calculators. Rotterdam was the best performer. Conclusions PCAs are currently in its infancy and do require further development before widespread integration into existing clinical practise. There are concerns with data protection, high readability standards and lack of information update in current PCAs. If developed appropriately with responsible governance, they do have the potential to play important roles in modern-day prostate cancer management

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Section: Individual Applications Includes Studies Evaluated By the Aumentioning

confidence: 97%

Do prostate cancer-related mobile phone apps have a role in contemporary prostate cancer management? A systematic review by EAU young academic urologists (YAU) urotechnology group

et al. 2020

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“…These data construct important parts prepared to publication after comparison analysis. Except these, reassessment on feedback data also help us conduct better medical training for our doctors and researchers 8,11 .…”

Section: Analysis Based On Educational Intervention and Patient Feedbackmentioning

confidence: 99%

“…Some of patients are admitted to hospital for further operation treatment, radiotherapy or chemotherapy based on abovementioned assessment, of which the clinical information about basic characteristics and examination indexes are recorded in medical records 7,8 . Some of patients are only follow-up in outpatient department and subjected to watchful waiting, active surveillance or drug therapy.…”

Section: Management On Clinical Samplementioning

confidence: 99%

Clinical File Management, Translational Research and Continuing Education for Cancer: a Single-unit Experience

Tong

2020

Preprint

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Background: Cancer is considered clinically heterogeneous. Some cancers are indolent and localized, while others are aggressive and easily spread to other parts of the body with metastasis. Whether diagnosis methods or therapy selection has moved towards combination, personalization and diversity. Therefore, it is important to standardize clinical file management, biospecimen collection and translational research of cancer.Methods: Data were retrieved from the Clinical Study Project on Cancer in XXXX, an ongoing longitudinal study including more than 1500 genitourinary cancer people.Results: The standard clinical diagnosis, treatment and translational research workflow was built based on current medical administration technology, molecular research method and triangle coordination relationship among doctor, patient and researcher. Raised awareness of warning signs and improved healthy styles showed high-quality follow-up and clinical outcome. At last, the system helps research ability improvement based on the skills proficiency and achieve medicine-research-education integration. Conclusion: Our analysis will help ensure patient health, enhance doctor-patient relationship, improve research efficiency and support continuing education. The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised clinical management and education intervention. Furthermore, successful work outcomes often involve the cooperation of doctors, cancer survivors and clinical researchers.

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“…However, not all prostate cancer decision aids are created equal, and many are subject to bias. Ironically and paradoxically, a pooled analysis of 19 randomized studies showed no difference in the decision to undergo screening whether a decision aid was used but did show a small decrease in decisional conflict …”

Section: Type Of Bias Potentially Affecting Men and Physicians Regardmentioning

confidence: 99%

Recognizing and minimizing bias: Helping patients make their best choice for prostate cancer management through multidisciplinary clinics

Eggener

2019

Cancer

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We would all agree that patient-centered care is the utopian ideal: a well-informed individual, educated by experienced, knowledgeable, thoughtful, unrushed clinicians providing unbiased, selfless advice. Unfortunately, but expectedly, this appears to be relatively rare. There are far too many counterproductive incentives, some obvious, many overt, whereas others are more subtle and even subconscious.The operating system of humans is hard-wired with bias, and it is utterly fascinating how presumably wellintentioned physicians present data and offer recommendations. Equally fascinating but utterly sordid is listening to a physician rationalize self-serving advice that conflicts with the best interests of the patient. Similarly, engaged patients often reach erroneous conclusions (because of or despite their physician), deceiving themselves into making what appears to be a poor decision.The science of behavioral economics has blossomed over the past few decades and is well beyond the scope of this amateur author or editorial. For a terse but expansive overview of the psychology of decision making, consider a recent Business Insider article 1 ; for a deeper dive, consider Thinking Fast and Slow by Nobel Prize in Economics winner Daniel Kahneman.Patients can be afflicted with zero-risk bias, outcome bias, information bias, hyperbolic discounting, clustering illusion, anchoring bias, bandwagon effect, or postpurchase rationalization. Physicians fall prey to self-enhancing transmission bias, status quo bias, conservatism bias, or relative value unit/financial bias. Both groups can be deluded by survivorship bias, innovation bias, herding, and confirmation bias ( Table 1).As it relates to prostate cancer, we have been told men should choose to undergo prostate-specific antigen-based screening based on their values and preferences, educated through informed and shared decision making, after thoroughly understanding the risks and benefits. The US Preventive Services Task Force recommends men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and incorporate their values and preferences into the decision. Hooey!! Although I am not aware of existing observational data, I suspect the overwhelming proportion of men in the United States are "assigned" to a screening versus no-screening decision by their physician. It is a rare urologist, let alone primary care physician, who can dually quantify and articulate the intricacies of prostate cancer screening, a concept I find challenging to summarize for a focused conference presentation.Admirably, decision aids strive to equip the individual with high-quality, tempered, and accurate information. Decision aids aim to summarize best available evidence and deliver it via printed material, computer-based, videos, or group sessions. However, not all prostate cancer decision aids are created equal, and many are subject to bias. Ironically and paradoxically, a pooled analysis of 19 randomized studies showed no difference in the decisio...

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Decision aids for prostate cancer screening choice: A systematic review and meta-analysis

Abstract: IMPORTANCE US guidelines recommend that physicians engage in shared decision-making with men considering prostate cancer screening. OBJECTIVE To estimate the association of decision aids with decisional outcomes in prostate cancer screening.

Cited by 23 publications

References 1 publication

Do prostate cancer-related mobile phone apps have a role in contemporary prostate cancer management? A systematic review by EAU young academic urologists (YAU) urotechnology group

Do prostate cancer-related mobile phone apps have a role in contemporary prostate cancer management? A systematic review by EAU young academic urologists (YAU) urotechnology group

Clinical File Management, Translational Research and Continuing Education for Cancer: a Single-unit Experience

Recognizing and minimizing bias: Helping patients make their best choice for prostate cancer management through multidisciplinary clinics

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