학술논문
Decision aid and cost compensation influence uptake of PSA-based early detection without affecting decisional conflict: a cluster randomised trial.
Document Type
Academic Journal
Author
Tiedje D; Prostate Center, University Hospital Muenster, Muenster, Germany. dorothee.tiedje@ukmuenster.de.; Borowski M; Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.; Simbrich A; Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.; Schlößler K; Department of General Practice/Family Medicine, Philipps-University Marburg, Marburg, Germany.; Department of General Practice/Family Medicine, Ruhr-University Bochum, Bochum, Germany.; Kruse K; Prostate Center, University Hospital Muenster, Muenster, Germany.; Bothe C; Prostate Center, University Hospital Muenster, Muenster, Germany.; Kuss K; Department of General Practice/Family Medicine, Philipps-University Marburg, Marburg, Germany.; Adarkwah CC; Department of General Practice/Family Medicine, Philipps-University Marburg, Marburg, Germany.; Maisel P; Department of General Medicine, University Hospital Muenster, Muenster, Germany.; Jendyk R; Department of General Medicine, University Hospital Muenster, Muenster, Germany.; Kurosinski MA; Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.; Gerß J; Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.; Tschuschke C; Berufsverband der Deutschen Urologen, Landesverband Westfalen-Lippe, Muenster, Germany.; Becker R; Hausaerzteverbund Muenster, Muenster, Germany.; Roobol MJ; Department of Urology, Erasmus University Medical Centre, Cancer Institute, Rotterdam, The Netherlands.; Bangma CH; Department of Urology, Erasmus University Medical Centre, Cancer Institute, Rotterdam, The Netherlands.; Hense HW; Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.; Donner-Banzhoff N; Department of General Practice/Family Medicine, Philipps-University Marburg, Marburg, Germany.; Semjonow A; Prostate Center, University Hospital Muenster, Muenster, Germany.
Source
Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
Subject
Language
English
Abstract
International guidelines recommend to inform men about the benefits and harms of prostate specific antigen (PSA) based early detection of prostate cancer. This study investigates the influence of a transactional decision aid (DA) or cost compensation (CC) for a PSA test on the decisional behaviour of men. Prospective, cluster-randomised trial to compare two interventions in a 2 × 2 factorial design: DA versus counselling as usual, and CC versus noCC for PSA-testing. 90 cluster-randomised physicians in the administrative district of Muenster, Germany recruited 962 participants aged 55-69 yrs. in 2018. Primary endpoint: the influence of the DA and CC on the decisional conflict. Secondary endpoints: factors which altered the involvement of the men regarding their decision to take a PSA-test. The primary endpoint was analysed by a multivariate regression model. The choice to take the PSA test was increased by CC and reduced by the DA, the latter also reduced PSA uptake in men who were offered CC. The DA led to an increase of the median knowledge about early detection, changed willingness to perform a PSA test without increasing the level of shared decision, giving participants a stronger feeling of having made the decision by themselves. The DA did not alter the decisional conflict, as it was very low in all study groups. DA reduced and CC increased the PSA uptake. The DA seemed to have a greater impact on the participants than CC, as it led to fewer PSA tests even if CC was granted.Trial registration: German Clinical Trial Register (Deutsches Register Klinischer Studien DRKS00007687). Registered: 06/05/2015. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00007687 .
(© 2021. The Author(s).)
(© 2021. The Author(s).)