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Informed decision making: what is its role in cancer screening?
Barbara K Rimer1, Peter A Briss, Paula K Zeller
1Department of Health Behavior and Health Education, School of Public Health, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7295, USA. brimer@email.unc.edu
Cancer
|August 19, 2004
Summary
Informed decision making (IDM) and shared decision making (SDM) improve patient knowledge but have variable effects on screening uptake. More research is needed to assess benefits and tailor interventions.
Area of Science:
- Health Services Research
- Patient-Centered Care
- Medical Decision Making
Background:
- Patient involvement in healthcare decisions is crucial for improving quality of care.
- Informed Decision Making (IDM) is increasingly recognized as a key component of patient-centered care.
- Understanding IDM, Shared Decision Making (SDM), and informed consent is essential for effective patient engagement.
Purpose of the Study:
- To provide an overview of Informed Decision Making (IDM) in healthcare.
- To clarify the distinctions between IDM, Shared Decision Making (SDM), and informed consent.
- To review the existing evidence on IDM interventions for cancer screening and identify research gaps.
Main Methods:
- Systematic review of published meta-analyses and a report from the CDC's Guide to Community Preventive Services.
- Focused on evidence related to IDM and SDM interventions for cancer screening.
- Analysis of studies examining the impact of interventions on knowledge, beliefs, risk perceptions, screening uptake, and patient preferences.
Main Results:
- IDM and SDM interventions, including decision aids, effectively enhance patient knowledge, beliefs, and risk perceptions.
- Evidence is limited regarding the impact of these interventions on patient participation levels and satisfaction with the decision-making process.
- Intervention effects on cancer screening uptake were variable: small decreases in prostate cancer screening and small increases in breast and colorectal cancer screening were observed.
Conclusions:
- While IDM/SDM interventions improve understanding, their impact on patient preferences and satisfaction requires further investigation.
- Facilitating patient participation in IDM is recommended for individuals who desire it.
- Significant research is needed to assess the full benefits of IDM/SDM, tailor interventions, address system barriers, integrate IDM into clinical practice, and evaluate potential unintended consequences.
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