Related Experiment Video
Updated: Jul 10, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Informed Decision-Making for Prostate Cancer Screening: A Prospective, Randomized Study of 2 Novel Web-Based,
Joseph Presti1,2, Stephanie Prausnitz2, Andrea Altschuler2
1Department of Urology, Kaiser Permanente Northern California, San Francisco, California.
Purpose:
The aim of this study was to conduct a quality improvement study testing 2 novel, web-based, electronic visits (E-visits) enabling men to make a decision regarding prostate cancer screening.
Materials And Methods:
Three thousand two hundred screen-eligible men in Kaiser Permanente, Northern California, equally comprised of 4 self-reported race/ethnicity categories (Asian, Black, Hispanic, and White) were randomly assigned to one of 2 E-visits: one purely informational providing general information on the risks and benefits of screening (informational E-visit) and the second (interactive E-visit), incorporating a personalized estimate for the risk of having an elevated prostate-specific antigen (PSA) level based on the patient's age and race. Completion rates of the E-visits and whether a decision on screening was made were the main outcomes.
Results:
The overall completion rate was similar by E-visit type (overall 15.6%, informational E-visit 16.2%, interactive E-visit 14.7%, P = .24). White men had the highest completion rate and Black men the lowest (18.5% vs 13.1%, P = .02). Older men aged 60 to 69 years had a higher completion rate than younger men aged 50 to 59 years (18.8% vs 15.4%, P = .045). Among those who completed an E-visit, those completing the interactive E-visit were more likely to make a decision regarding screening (98.7% vs 91.2%, P < .001) and were more likely to request a PSA test (96.2% vs 90.0%; P = .008) compared with those completing the informational E-visit.
Conclusions:
Race and age were associated with completion rates of these E-visits. Among men completing the visit, those completing the interactive E-visit were more likely to make a decision regarding screening and order a PSA test than those completing the informational E-visit.
