Supporting informed decision making for prostate specific antigen (PSA) testing on the web: an online randomized...

Area of Science:

• Urology
• Public Health
• Health Informatics

Background:

• Prostate cancer is a common male cancer, necessitating informed decisions regarding screening.
• The prostate-specific antigen (PSA) test has limitations in accuracy and understanding of prostate cancer's natural history.
• Prosdex, a web-based decision aid, was developed to support informed decision-making for the PSA test.

Purpose of the Study:

• To evaluate the impact of the Prosdex web-based decision aid on informed decision-making for prostate cancer screening.
• To assess changes in knowledge, attitudes, and behavioral intentions related to PSA testing.

Main Methods:

• A randomized controlled trial involving 514 men aged 50-75 who had not previously undergone PSA testing.
• Intervention groups viewed either a web-based (Prosdex) or paper version of the decision aid.
• Outcomes included knowledge, attitudes, decisional conflict, anxiety, and PSA test uptake, measured via online/paper questionnaires and GP records at six months.

Main Results:

• Men using Prosdex showed increased knowledge of prostate cancer and PSA testing.
• Prosdex use was associated with less favorable attitudes toward PSA testing and lower intention to undergo the test.
• PSA test uptake was significantly lower in the Prosdex group compared to control groups after six months.

Conclusions:

• The Prosdex decision aid enhances knowledge regarding PSA testing and prostate cancer.
• Increased knowledge correlates with less favorable attitudes and reduced likelihood of undergoing PSA testing.
• Prosdex effectively promotes informed decision-making by providing comprehensive information, leading to more considered choices about PSA testing.