Key Elements of Mammography Shared Decision-Making: a Scoping Review of the Literature

DuBenske, Lori L.; Schrager, Sarina; Hitchcock, Mary; Kane, Amanda K.; Little, Terry A.; McDowell, Helene; Burnside, Elizabeth S.

doi:10.1007/s11606-018-4576-6

Cited by 23 publications

(19 citation statements)

References 34 publications

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“…A large portion of the items accepted by our panelists as core elements of SDM (29 of 44) were derived from a scientific literature review. 17 Our panelists have therefore affirmed SDM principles as found in the literature. In addition, by inviting panelists to suggest items for other panelists to consider, and by achieving consensus on those suggested items in subsequent rounds, our panelists identified several core elements of SDM not found in the empirical literature, spanning across the thematic categories of information delivery and patient education, framework of the decision, and interpersonal clinicianpatient communication.…”

Section: Framework Of the Decisionsupporting

confidence: 71%

“…The content for round one of the Delphi survey was derived from our previously published scoping literature review (see DuBenske et al for methodological details and findings). 17 Briefly, this review extracted original articles and editorials addressing empirical evidence reporting on breast cancer screening, medical decision-making, and patient centered care. Reviewers extracted critical findings related to breast cancer screening SDM elements (e.g., structural components, processes, and delivery modes).…”

Section: Development Of Items For Round One Of the Delphi Surveymentioning

confidence: 99%

“…The same 5-point response scale was offered for all items: not at all important, slightly important, somewhat important, very important, and extremely important. Round one consisted of 32 Likert-type items from the literature review 17 and five open-ended items for panelists to suggest new items for round two. Round one panelists suggested 48 new items for round two.…”

Section: Overview Of Survey Roundsmentioning

confidence: 99%

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Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey

et al. 2020

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BACKGROUND: The United States Preventive Services Task Force recommends individualized breast cancer screening for average-risk women before age 50, advised by risk assessment and shared decision-making (SDM). However, the foundational principles of this recommendation that would inform decision support tools for patients and primary care physicians at the point of care have not been codified. Determining the core elements of SDM for breast cancer screening as valued by patients and primary care providers (PCPs) is necessary for implementing effective SDM tools. The aim of this study is to affirm core elements of SDM in the context of clinical interactions, through a Delphi consensus process. METHODS: A Delphi was conducted with 30 participants (10 women aged 40-49, 10 PCPs, and 10 healthcare decision scientists), to codify core elements of breast cancer screening SDM. The criterion for establishing consensus was a threshold of 80% agreement. The Delphi concluded with an 83% response rate. RESULTS: Of 48 items fielded, 44 met the threshold on the high-importance end of the response scale and were accepted as core elements. Core elements across three thematic categories-information delivery and patient education, interpersonal clinician-patient communication, and framework of the decision-received panelists' support in nearly equal measure. Panelists unanimously agreed that SDM should include provision of clearly understandable information, including that of personal breast cancer risk factors, and benefits and harms of mammography screening, and that PCPs should convey they are listening, knowledgeable, and demonstrate cultural sensitivity. DISCUSSION: This research codifies the core elements of SDM for mammography in women 40-49, augmenting the evidence to inform discussions between patients and physicians. These core elements of SDM have the potential to operationalize SDM for breast cancer screening in an effort to improve public health outcomes.

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Section: Framework Of the Decisionsupporting

confidence: 71%

Section: Development Of Items For Round One Of the Delphi Surveymentioning

confidence: 99%

Section: Overview Of Survey Roundsmentioning

confidence: 99%

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Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey

et al. 2020

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“…However, none of those reviews focused on the quality of the decision aids themselves. Another publication proposed an inventory of the key elements of shared decisions (specific content, type of communication, and framework) 60 . Finally, Jimbo et al analyzed 73 decision aids focusing on cancer screening, 61 but the most recent study in their review was published in 2010.…”

Section: Discussionmentioning

confidence: 99%

Quality of decision aids developed for women at average risk of breast cancer eligible for mammographic screening: Systematic review and assessment according to the International Patient Decision Aid Standards instrument

Hild

Johanet

Valenza

et al. 2020

Cancer

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Mammographic screening contributes to a reduction in specific mortality, but it has disadvantages. Decision aids are tools designed to support people's decisions. Because these aids influence patient choice, their quality is crucial. The objective of the current study was to conduct a systematic review of decision aids developed for women eligible for mammographic screening who have an average breast cancer risk and to assess the quality of these aids. The systematic review included articles published between January 1, 1997, and August 1, 2019, in the PubMed, Embase, Cochrane, and PsycInfo databases. The studies were reviewed independently by 2 reviewers. Any study containing a decision aid for women eligible for mammographic screening with an average breast cancer risk was included. Two doubleblind reviewers assessed the quality of the selected decision aids using the International Patient Decision Aid Standards instrument, version 3 (IPDASi). Twenty-three decision aids were extracted. Classification of decision aid quality using the IPDASi demonstrated large variations among the decision aids (maximum IPDASi score, 188; mean ± SD score, 132.6 ± 23.8; range, 85-172). Three decision aids had high overall scores. The 3 best-rated dimensions were disclosure (maximum score, 8; mean score, 6.8), focusing on transparency; information (maximum score, 32; mean score, 26.1), focusing on the provision of sufficient details; and probabilities (maximum score, 32; mean score 25), focusing on the presentation of probabilities. The 3 lowest-rated dimensions were decision support technology evaluation (maximum score, 8; mean score, 4.3), focusing on the effectiveness of the decision aid; development (maximum score, 24; mean score, 12.6), evaluating the development process; and plain language (maximum score, 4; mean score, 1.9), assessing appropriateness for patients with low literacy. The results of this review identified 3 high-quality decision aids for breast cancer screening. Cancer 2020;126:2765-2774.Breast cancer is the leading cause of women's mortality worldwide. 1 Screening programs based on mammography lead to a 15% to 20% reduction in specific mortality. 2,3 However, assessing the benefits and harms of these programs requires taking into account the biases and disadvantages of mammographic screening. 2 The most important harms of this screening are false-positive results, overdiagnosis, overtreatment, and radiation-induced cancer. 4 The cumulative risk of a false-positive result ranges from 3% to 63% for a woman exposed to annual mammographic screening between ages 50 and 70 years. 5,6 In this context, clinicians may feel uncomfortable submitting their patients to this screening process without using a shared decision-making process. 7 There is now a consensus that patients should have the opportunity to participate in decisions about their health. 8,9 They should understand whether there are options and the related consequences of these options. Patient preferences should be integrated into decision making. 10 Decis...

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“…The telehealth consult is a 'shared care' experience for all parties (Figure 2). [10][11][12][13][14]…”

Section: Formulation Elementmentioning

confidence: 99%

Telehealth: An area that aligns with general practitioners’ expertise

Butel¹

2021

Aust J Gen Pract

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Key Elements of Mammography Shared Decision-Making: a Scoping Review of the Literature

Cited by 23 publications

References 34 publications

Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey

Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey

Quality of decision aids developed for women at average risk of breast cancer eligible for mammographic screening: Systematic review and assessment according to the International Patient Decision Aid Standards instrument

Telehealth: An area that aligns with general practitioners’ expertise

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