Personalised risk communication for informed decision making about taking screening tests

Edwards, Adrian; Naik, Gurudutt; Ahmed, Haroon; Elwyn, Glyn; Pickles, Timothy; Hood, Kerenza; Playle, Rebecca

doi:10.1002/14651858.cd001865.pub3

Cited by 227 publications

(197 citation statements)

References 128 publications

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“…Some published studies have found that communicating tailored messages positively impacts recruitment and engagement, increasing the uptake and referral to these services (17). Proactive engagement of smokers by personalizing the advice and communicating the risk factors tailored to the individual works as a good engagement strategy.…”

mentioning

confidence: 99%

Personalised information for improving the uptake of smoking cessation programs

Semwal¹,

Taylor

Car³

2017

Ann. Transl. Med.

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mentioning

confidence: 99%

Personalised information for improving the uptake of smoking cessation programs

Semwal¹,

Taylor

Car³

2017

Ann. Transl. Med.

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“…Other indirect evidence for benefit comes from limited findings of improvements with medical and surgical patients' knowledge related to use of personalized risk communications (Edwards et al 2013) or decision aids (Knops et al 2013). Decisional conflict also shows some reductions related to use of decision aids (Stacey et al 2011).…”

Section: Rationalementioning

confidence: 99%

The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

Association¹

2015

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“…In an arena confusing even to many professionals, we are clearly failing our audience in often achieving patient-professional discussions and online patient education materials of only minimal comprehensibility. Fortunately, patient decision aids based on validated measures of the primary outcome (informed choice) can improve informed values-based choices, patient-practitioner communication, and realistic perception of outcomes while reducing decisional conflict [84][85][86] . One such is the online Breast Cancer Screening Decision Aid (from the Public Health Agency of Canada) [87][88][89] , with its quantitative estimates of major risks and benefits of screening; another is the BreastScreen Australia decision aid 90 , the first mammography screening decision aid validated in a randomized controlled trial 91 .…”

Section: Communicating the Harmsmentioning

confidence: 99%

Beyond the Mammography Debate: A Moderate Perspective

Kaniklidis¹

2015

Current Oncology

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After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete.To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patientaccessible levels to facilitate informed decisions. Key Words REFLECTIONS ON SOME CENTRAL THEMESAll screening programmes do harm; some do good as well, and, of these, some do more good than harm at reasonable cost.-Sir Muir Grey, former director of the U.K. National Screening Committee 1 Some Issues Deserving More AttentionSeveral core issues require closer examination:1. The potential benefits of mammographic screening independent of whether ultimate survival is affected, including diagnosis at earlier stages, typically with smaller tumours and node negativity; reduced likelihood of aggressive treatments and morbidities; detection of high-risk lesions (most diagnosed in the screened group 2 ) allowing for chemoprevention or magnetic resonance imaging (mri) surveillance against occult malignancies, or both; and avoidance of compromised quality of life after diagnosis of advanced disease It is not clear, as often assumed, that survival is the best (or only) measure for judging mammographic screening 2,3 . And it remains open whether claimed harms truly are disproportionate to benefits when using, for instance, a more nuanced definition of overdetection than simply breast cancer (bca) diagnosed but not bca expired (distinguishing, for example, longer recurrence-free survival from simple overall survival benefit).

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Personalised risk communication for informed decision making about taking screening tests

Abstract: Analysis 1.11. Comparison 1 personalised risk communication versus general risk information, Outcome 11 smoking. Analysis 1.13. Comparison 1 personalised risk communication versus general risk information, Outcome

Cited by 227 publications

References 128 publications

Personalised information for improving the uptake of smoking cessation programs

Personalised information for improving the uptake of smoking cessation programs

The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

Beyond the Mammography Debate: A Moderate Perspective

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