Informed choice for screening: implications for evaluation

Irwig, L. M.; McCaffery, Kirsten; Salkeld, Glenn; Bossuyt, Patrick M.

doi:10.1136/bmj.332.7550.1148

Cited by 84 publications

(71 citation statements)

References 18 publications

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“…10 In turn, key performance indicators for screening should reflect informed choice rather than participation. 9,11,12 Despite calls for better information about overdetection for women invited to breast screening, few studies have reported public responses to this issue. In qualitative studies, screening-eligible women were unaware of overdetection but could understand the concept, valued information, and considered it important to make informed decisions.…”

Section: Introductionmentioning

confidence: 99%

“…20 Screening rates may not reflect people"s informed decisions if coercion or obstacles are present. 12 In this study, therefore, our key question was whether evidence-based, consumer-friendly information on overdetection improves the level of informed choice about screening in a community sample of women around the target age for starting breast screening in Australia.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…13,14 The complexity of measuring informed choice, because of the different ways informed choice has been defined and measured in a range of screening settings, has been recognised. 12,[14][15][16] Here we present the findings of a systematic review focussing on reproductive genetic screening in the general population, where screening was used to assess risk of a genetic condition in current or future pregnancies. A variety of conditions are included such as Down syndrome (DS) and single gene disorders.…”

Section: Introductionmentioning

confidence: 99%

Measuring informed choice in population-based reproductive genetic screening: a systematic review

et al. 2014

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Genetic screening and health-care guidelines recommend that programmes should facilitate informed choice. It is therefore important that accurate measures of informed choice are available to evaluate such programmes. This review synthesises and appraises measures used to evaluate informed choice in population-based genetic screening programmes for reproductive risk. Databases were searched for studies offering genetic screening for the purpose of establishing reproductive risk to an adult population sample, in which aspects of informed choice were measured. Studies were included if, at a minimum, measures of uptake of screening and knowledge were used. Searches identified 1462 citations and 76 studies were reviewed in full text; 34 studies met the inclusion criteria. Over 20 different measures of informed choice were used. Many measures lacked adequate validity and reliability data. This systematic review will inform future evaluation of informed choice in population genetic screening programmes.

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“…Given the need for bowel regimens before endoscopy procedures and inability to eat for up to a day in patients who may already be nutritionally bereft, these tests also have some potential associated morbidity. Additionally, significant psychological consequences include increased anxiety and stress while waiting for diagnostic testing to be performed (11). Routine mammography for breast cancer screening can also lead to false-positive results in women with advanced CKD and ESRD.…”

Section: Recommendationsmentioning

confidence: 99%

Critical and Honest Conversations

Williams¹,

Dwyer²,

Eddy³

et al. 2012

Clinical Journal of the American Society of Nephrology

162

115

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SummaryEstimates suggest that one third of United States health care spending results from overuse or misuse of tests, procedures, and therapies. The American Board of Internal Medicine Foundation, in partnership with Consumer Reports, initiated the "Choosing Wisely" campaign to identify areas in patient care and resource use most open to improvement. Nine subspecialty organizations joined the campaign; each organization identified five tests, procedures, or therapies that are overused, are misused, or could potentially lead to harm or unnecessary health care spending. Each of the American Society of Nephrology's (ASN's) 10 advisory groups submitted recommendations for inclusion. The ASN Quality and Patient Safety Task Force selected five recommendations based on relevance and importance to individuals with kidney disease.Recommendations selected were: (1) Do not perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms; (2) do not administer erythropoiesis-stimulating agents to CKD patients with hemoglobin levels ‡10 g/dl without symptoms of anemia; (3) avoid nonsteroidal anti-inflammatory drugs in individuals with hypertension, heart failure, or CKD of all causes, including diabetes; (4) do not place peripherally inserted central catheters in stage 3-5 CKD patients without consulting nephrology; (5) do not initiate chronic dialysis without ensuring a shared decision-making process between patients, their families, and their physicians.These five recommendations and supporting evidence give providers information to facilitate prudent care decisions and empower patients to actively participate in critical, honest conversations about their care, potentially reducing unnecessary health care spending and preventing harm.

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Informed choice for screening: implications for evaluation

Cited by 84 publications

References 18 publications

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

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

Measuring informed choice in population-based reproductive genetic screening: a systematic review

Critical and Honest Conversations

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