Value-Based Decision-Making in Prostate Cancer Early Detection
Final rept. 1 Oct 1998-31 Oct 2003
THOMAS JEFFERSON UNIV PHILADELPHIA PA
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This report describes a randomized trial of an intervention designed to facilitate informed decision-making about prostate cancer screening. The study population included 199 adult men in the patient population of a university-based internal medicine practice. Participants completed a baseline survey and were randomly assigned to either a Standard Intervention SI Group n99 or an Enhanced Intervention EI Group n100. Men in both groups were mailed a prostate cancer informational booklet. The EI Group was offered a decision counseling session to clarify personal preferences about screening. Six months later, a medical chart audit was performed. Screening utilization was defined in two ways. The primary outcome defined utilization as having both a digital rectal exam DRE and a prostate specific antigen PSA test. The secondary outcome was defined less strictly to reflect common practice among physicians. It regarded a PSA test, with or without a DRE, as screening. For the primary outcome, the El Group had lower screening rates than the SI Group 8 vs. 12. For the secondary outcome, the rates were similar 18.0 vs. 18.2 respectively. Neither of these effects was statistically significant. Results of multivariable analyses showed that race was a significant predictor of the secondary outcome p0.012.
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