(Press-News.org) WASHINGTON – Men who decide to be screened for prostate cancer and those who forgo PSA screening stick with their decisions after receiving materials explaining the risks and benefits of the test. The decision aids greatly increased their knowledge about screening and reduced their conflict about what to do, but did not have an impact on their screening decision when measured a year later.
That's the finding of a new study published today in JAMA Internal Medicine that examined both web-based and printed tools aimed at helping men make informed decisions about PSA testing.
In May 2012, the US Preventive Services Task Force recommended against screening all men for prostate cancer. Most health professional groups recommend shared decision making so that men can understand the limitations of screening before making a decision about being tested.
"The history of conflicting recommendations for prostate cancer screening and the mixed messages about screening effectiveness make it critical to assist men in making informed decisions," explains Kathryn Taylor, Ph.D., professor in the Cancer Prevention and Control Program at Georgetown Lombardi Comprehensive Cancer Center.
Taylor and her colleagues developed two decision aids to help men weigh the pros and cons of testing and then make informed decisions about screening. In one of the largest and most representative randomized trials conducted on this topic, a racially diverse group of 1,879 men aged 45 to 70 were randomly assigned to utilize a print-based decision aid, an interactive web-based decision aid, or usual care (no decision aid). Telephone interviews were conducted at the start of the study, one month after the start and again at 13 months to see if the tool had a long-term impact.
"The tools were intended neither to encourage nor discourage screening, but instead to present the benefits and limitations of screening to help men make choices consistent with their preferences," Taylor explains.
After the surveys were conducted, the researchers found that both the web-based and print tools increased the men's knowledge and reduced the initial conflict they reported about whether or not to be screened, and increased their immediate satisfaction with their decision.
"Interestingly, we thought these decision aids might lead to more men forgoing testing, but in fact, the men didn't change their screening plans," says Taylor, adding, "The men told us these tools helped them resolve their own conflicts about whether or not to receive screening." And the study suggested a positive trend in men's long-term satisfaction with their decisions, important because men face the decision about screening every year.
"Ultimately, the decision to receive PSA screening for prostate cancer lies with men," Taylor concludes. "They'll be able to make decisions that are right for them if they have unbiased, updated screening materials that fully explain the risks and benefits," Taylor says.
Importantly, the print- and web-based decision aids were equally effective in improving knowledge and reducing decisional conflict, suggesting that either tool may be used, depending on an individual's preferred medium, Taylor says.
"They both have the potential to be easily adopted in real-world practice settings," Taylor concludes. "Given the demonstrated beneficial effect of the decision aids, work is now needed to understand the best methods for widespread dissemination."
###
Taylor reports having no personal financial interests related to the study.
About Georgetown Lombardi Comprehensive Cancer Center
Georgetown Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center and MedStar Georgetown University Hospital, seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Georgetown Lombardi is one of only 41 comprehensive cancer centers in the nation, as designated by the National Cancer Institute (grant #P30 CA051008), and the only one in the Washington, DC area. For more information, go to http://lombardi.georgetown.edu.
About Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. END
Decision aids reduce men's conflict about PSA screening, but don't change their decisions
2013-07-30
ELSE PRESS RELEASES FROM THIS DATE:
Playing college football linked with high blood pressure risk
2013-07-30
College football players, especially linemen, may develop high blood pressure over the course of their first season, according to a small study in the American Heart Association's journal Circulation.
Researchers documented higher blood pressure levels among 113 first-year college players. Only one player had already been diagnosed with hypertension before the season and 27 percent had a family history of hypertension. At post-season, researchers noted:
47 percent of players were considered pre-hypertensive, while
14 percent had stage 1 hypertension.
While previous ...
Treatment for back pain varies despite published clinical guidelines
2013-07-30
Management of back pain appears to be variable, despite numerous published clinical guidelines, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
Spinal symptoms are among the most common reasons patients visit a physician and more than 10 percent of visits to primary care physicians relate to back and neck pain, the authors write in the study background.
John N. Mafi, M.D., of Harvard Medical School, Boston, and colleagues used nationally representative data from the National Ambulatory Medical Care Survey and the National Hospital ...
Adolescent kidney transplant recipients appear to be at higher risk of transplant failure
2013-07-30
Patients who received their first kidney transplant at ages 14 to 16 years appear to be at increased risk for transplant failure, with black adolescents having a disproportionately higher risk of graft failure, according to a report published by JAMA Internal Medicine, a JAMA Network publication.
Existing medical literature does not adequately describe the risks of graft failure among kidney transplant recipients by age. Organ losses by adolescents are partly due to physiologic or immunologic changes with age but psychological and sociological factors play a role, especially ...
Decision aids associated with increase in informed decision making about prostate cancer screening
2013-07-30
Both web-based and print-based decision aids appear to improve patients' informed decision making about prostate cancer screening up to 13 months later, but does not appear to affect actual screening rates, according to a study by Kathryn L. Taylor, Ph.D., of Georgetown University, Washington, D.C., and colleagues.
A total of 1,893 men participated in the study, with 628 men randomly given a print-decision aid, 625 men used a web-based interactive decision aid, and 626 men received usual care. Researchers measured the participants' prostate cancer knowledge, decisional ...
Breastfeeding duration appears associated with intelligence later in life
2013-07-30
Breastfeeding longer is associated with better receptive language at 3 years of age and verbal and nonverbal intelligence at age 7 years, according to a study published by JAMA Pediatrics, a JAMA Network publication.
Evidence supports the relationship between breastfeeding and health benefits in infancy, but the extent to which breastfeeding leads to better cognitive development is less certain, according to the study background.
Mandy B. Belfort, M.D., M.P.H., of Boston Children's Hospital, and colleagues examined the relationships of breastfeeding duration and exclusivity ...
Glucose intolerance, diabetes or insulin resistance not linked with pathological features of AD
2013-07-30
Glucose intolerance or insulin resistance do not appear to be associated with pathological features of Alzheimer disease (AD) or detection of the accumulation of the brain protein β-amyloid (Αβ), according to a report published by JAMA Neurology, a JAMA Network publication.
Glucose intolerance and diabetes mellitus have been proposed as risk factors for the development of AD, but evidence of this has not been consistent, the study background notes.
Madhav Thambisetty, M.D., Ph.D., of the National Institute on Aging, Baltimore, and colleagues investigated ...
Physicians should counsel patients about sex life after cardiac event
2013-07-30
Healthcare professionals are urged to counsel heart and stroke patients on how to resume a healthy sex life, according to a joint statement published in the American Heart Association journal Circulation and the European Heart Journal. It is the first scientific statement to offer detailed guidance for patients.
"Patients are anxious and often afraid sex will trigger another cardiac event – but the topic sometimes gets passed over because of embarrassment or discomfort," said Elaine Steinke, A.P.R.N., Ph.D., lead author of the statement and professor of nursing at Wichita ...
BIDMC study suggests worsening trends in back pain management
2013-07-30
BOSTON – Patient care could be enhanced and the health care system could see significant cost savings if health care professionals followed published clinical guidelines to manage and treat back pain, according to researchers at Beth Israel Deaconess Medical Center and published in the July 29 issue of JAMA Internal Medicine.
"Back pain treatment is costly and frequently includes overuse of treatments that are not supported by clinical guidelines, and that don't impact outcomes," says lead author John N. Mafi, MD, a fellow in the Division of General Medicine and Primary ...
NIH researchers identify therapy that may curb kidney deterioration in patients with rare disorder
2013-07-30
A team led by researchers at the National Institutes of Health has overcome a major biological hurdle in an effort to find improved treatments for patients with a rare disease called methylmalonic acidemia (MMA). Using genetically engineered mice created for their studies, the team identified a set of biomarkers of kidney damage—a hallmark of the disorder—and demonstrated that antioxidant therapy protected kidney function in the mice.
Researchers at the National Human Genome Research Institute (NHGRI), part of NIH, validated the same biomarkers in 46 patients with MMA ...
NIH math model predicts effects of diet, physical activity on childhood weight
2013-07-30
Researchers at the National Institutes of Health have created and confirmed the accuracy of a mathematical model that predicts how weight and body fat in children respond to adjustments in diet and physical activity. The results will appear online July 30 in The Lancet Diabetes and Endocrinology.
While the model may help to set realistic expectations, it has not been tested in a controlled clinical trial to determine if it is an effective tool for weight management.
The model evolved from one developed at the NIH in 2011 to predict weight change in adults. The model ...