scholarly journals Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016894 ◽  
Author(s):  
Montserrat Martínez-Alonso ◽  
Misericòrdia Carles-Lavila ◽  
Maria José Pérez-Lacasta ◽  
Anna Pons-Rodríguez ◽  
Montse Garcia ◽  
...  

ObjectiveThe aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer.SettingScreening for breast cancer.InterventionDAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes.Eligible studiesWe included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies’ risk of bias was assessed with the Cochrane Collaboration’s tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs.Primary and secondary outcomesThe main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened.ResultsA total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The meta-analysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened.ConclusionsTools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs.

2020 ◽  
Vol 9 (14) ◽  
pp. 985-1002
Author(s):  
Lin Yu ◽  
Ping Li ◽  
Shu Yang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  

Aim: Breast cancer is a leading cause of cancer among women. Because guidelines on screening for breast cancer for certain ages are controversial, many experts advocate the use of shared decision making (SDM) using validated decision aids (DAs). Recent studies have concluded that DAs are beneficial; however, the results have great heterogeneity. Therefore, further studies are needed to improve understanding of these tools. Objective: This systematic review and meta-analysis aimed to investigate the impact of using web-based DAs in women aged 50 years and below facing the decision to be screened for breast cancer in comparison with usual care. Methods: PubMed, Web of Science, Embase and the Cochrane CENTRAL databases were searched up to February 2020 for studies assessing web-based DAs for women making a breast cancer screening decision and reported quality of decision-making outcomes. Using a random-effects model or a fixed-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD) and relative risks (RR). Results: Of 1097 unique citations, three randomized controlled trials and two before–after studies met the study eligibility criteria. Compared with usual care, web-based DAs increased knowledge (SMD = 0.69; 95% CI: 0.57–0.80; p < 0.00001), reduced decision conflict and increased the proportion of women who made an informed choice (RR = 1.86; 95% CI: 1.38 to 2.50; p < 0.0001), but did not change the intention of women deciding to be screened or affect decision regret. Conclusion: This analysis showed the positive effect of web-based DAs on patient-centered outcomes in breast cancer screening. In the future, more internet devices and free or larger discount WI-FI should be established to ensure more women can benefit from this effective tool.


2019 ◽  
Vol 91 ◽  
pp. 518-526 ◽  
Author(s):  
Yurong Wang ◽  
Guijuan Zhang ◽  
Xiaoqian Hao ◽  
Yi Ma ◽  
Min Ma ◽  
...  

2021 ◽  
Vol 76 (2) ◽  
pp. 154.e11-154.e22 ◽  
Author(s):  
R. Geach ◽  
L.I. Jones ◽  
S.A. Harding ◽  
A. Marshall ◽  
S. Taylor-Phillips ◽  
...  

2019 ◽  
Vol 22 (2) ◽  
pp. 311
Author(s):  
Soo Yeon Song ◽  
Boyoung Park ◽  
Seri Hong ◽  
Min Jung Kim ◽  
Eun Hye Lee ◽  
...  

2019 ◽  
Author(s):  
Johanna Anderson ◽  
Donald S. Bourne ◽  
Kim A. Peterson ◽  
Katherine M. Mackey

Abstract Background: Guideline-based breast and cervical cancer screenings are fundamental components of high-quality preventive women’s health care services. Accurate measurement of screening rates is vital to ensure all women are adequately screened. Our systematic review and meta-analysis aims to provide an updated synthesis of the evidence on the accuracy of self-reported measures of cervical and breast cancer screening compared to medical records. Methods: To identify studies, we searched MEDLINE®, Cochrane Database of Systematic Reviews, and other sources up to July 2019. Two reviewers sequentially selected studies, abstracted data, and assessed internal validity and strength of the evidence. Adjusted summary numbers for sensitivity and specificity were calculated using a bivariate random-effects meta-analysis. Results: Unscreened women tended to over-report screening among 39 included studies examining the accuracy of self-report for cervical and/or breast cancer screening. The specificity of self-report was 48% (95% CI 41 to 56) for cervical cancer screening and 61% (95% CI 53 to 69) for breast cancer screening while the sensitivity of self-report was much higher at 96% (95% CI 94 to 97) for cervical cancer screening and 96% (95% CI 95 to 98). We have moderate confidence in these findings, as they come from a large number of studies directly assessing the accuracy of self-report compared to medical records and are consistent with findings from a previous meta-analysis. Conclusions: Unscreened women tend to over-report cervical and breast cancer screening, while screened women more accurately report their screening. Future research should focus on assessing the impact of over-reporting on clinical and system-level outcomes.


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