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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effect of Personalized Risk Messages on Patient Intent and Decision Making in Colorectal Cancer Screening: A
Peter H Schwartz1,2,3, Thomas F Imperiale1,4,5, Susan M Perkins6,7
1Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Summary
Personalized messages about advanced colorectal neoplasia (ACN) risk increased screening intent and stool test preference but decreased colonoscopy preference. Provider notifications improved informed concordance in one system.
Area of Science:
- Oncology
- Preventive Medicine
- Health Communication
Background:
- Colorectal cancer (CRC) screening is crucial for early detection.
- Personalized risk information may improve patient decision-making for CRC screening.
- Informed concordance is a key outcome in shared decision-making for cancer screening.
Purpose of the Study:
- To evaluate the impact of personalized advanced colorectal neoplasia (ACN) risk messages on CRC screening decisions.
- To assess the effect of personalized risk information on informed concordance and screening intent.
- To determine if provider notifications of patient ACN risk influence decision-making outcomes.
Main Methods:
- 1,084 average-risk patients (50-75 years) were randomized to a decision aid with or without personalized ACN risk.
- Providers received screening notifications with or without patient-specific ACN risk.
- Surveys assessed informed concordance, screening intent, and decision-making at multiple time points.
Main Results:
- Personalized ACN risk messages increased intent for any CRC screening and stool tests, while decreasing colonoscopy intent.
- No significant effect of either intervention on informed concordance was observed overall.
- In one health system, provider notification of ACN risk increased informed concordance.
Conclusions:
- Personalized ACN risk communication enhances screening intent and influences test preference.
- Provider-level risk communication may improve informed concordance in specific settings.
- Tailored risk messaging holds potential for optimizing CRC screening decision-making.
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