Helping women make choices about mammography screening: An online randomized trial of a decision aid for 40-year-old women

Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial

“…16 Questions (appendix) assessed understanding of screening outcomes (mortality benefit, overdetection, and false positives) and awareness of the approximate numbers affected. Scoring followed a marking scheme developed a priori (appendix).…”

“…13 We developed and revised the materials based on input from layperson collaborators and independent experts as well as a thorough piloting process. 18 availability) collected demographics, stage of decision making about breast screening, basic conceptual knowledge, 28 attitudes, 29 and intentions. 30 Women were then randomised and mailed their decision aid.…”

“…15 Only two of the trials identified were about decision aids in breast cancer screening: a booklet for women aged 70 years considering whether to continue or stop screening 16 and an online decision aid for women aged 40 years considering whether to start screening early or wait until age 50 years. 28 We searched Medline and PsycINFO for any additional articles published from 2012 to 31 December 2014. Search terms included "decision support", "decision aid", "shared decision making", "informed choice", "informed decision", "mammogra*", "breast cancer screening", and "breast screening".…”

“…Randomised trials have shown that decision aids improve knowledge and facilitate informed choice in various settings, 15 including cancer screening. 16,17 In breast screening, however, decision aids have not comprehensively addressed overdetection. The first evaluated mammography decision aid to acknowledge overdetection placed this information in an appendix, did not state its frequency, and was designed for 70-year-old women deciding whether to continue screening.…”

“…The first evaluated mammography decision aid to acknowledge overdetection placed this information in an appendix, did not state its frequency, and was designed for 70-year-old women deciding whether to continue screening. 16 There is a need for high-quality evidence on how information about the concept and magnitude of overdetection influences decision making in women entering the target age range for screening at 50 years (when screening is initiated in many countries).…”