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Comparing 3 techniques for eliciting patient values for decision making about prostate-specific antigen screening: a
Michael Patrick Pignone1, Kirsten Howard, Alison Tytell Brenner
1Cecil G. Sheps Center for Health Services Research, Universityof North Carolina at Chapel Hill, 725 Martin LutherKing Jr Blvd, Chapel Hill, NC 27599, USA. pignone@med.unc.edu
Different methods for clarifying patient values before prostate-specific antigen (PSA) screening influence decision-making. The rating and ranking task highlighted reducing prostate cancer death as most important, but intent for PSA testing remained similar across all methods.
Area of Science:
- Urology
- Decision Science
- Health Services Research
Background:
- Informed decision-making regarding prostate-specific antigen (PSA) screening requires men to weigh potential outcomes.
- Understanding how different methods affect value clarification is crucial for guiding these decisions.
Purpose of the Study:
- To evaluate the impact of three distinct values clarification methods on how men prioritize outcomes related to PSA screening.
- To assess the influence of these methods on screening preferences and intent.
Main Methods:
- A randomized trial involving 911 men aged 50-70 with average prostate cancer risk.
- Participants used one of three methods: balance sheet, rating and ranking, or discrete choice experiment.
- The primary outcome was the most important attribute identified post-intervention; secondary outcomes included screening preference and intent.
Main Results:
- The rating and ranking method led to a higher proportion prioritizing reduced mortality from prostate cancer compared to the other methods.
- The balance sheet method resulted in a greater preference for a PSA-like screening option.
- Intent to undergo PSA testing did not significantly differ across the three groups.
Conclusions:
- Values clarification methods demonstrably alter attribute importance and screening preferences.
- Further research is needed to identify optimal values clarification strategies for PSA screening decisions, using more distal outcome measures.
