New evidence about online prostate cancer screening decision aids

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Glyn Elwyn of Cardiff University, along with a team of colleagues, has a paper in the current Journal of Medical Internet Research about their attempt to examine men’s use of an online decision aid for prostate cancer screening. They conclude:

“There is evidence that Prosdex (the decision aid) promotes informed decision making in men, and we highlight factors that should inform the future design of decision aids. First, for the population using Prosdex, 20 minutes seems to be a critical time window in which we can realistically expect information to be accessed. This finding is significant as there has been a recent trend towards developing more sophisticated decision aids that take longer to use, which could be seen as over engineering. We demonstrated, however, that participants did not use the interactive features, and that the window of opportunity for information transfer to support decision making is narrow. Second, users of decision aids are not a homogenous population: there are different types of users characterized by their level of interaction with the decision aid. Therefore, developers need to design tools that sufficiently support and facilitate informed decision making among the different types of users, and should move away from designing one intervention for all.”

As one who produced some of the very early shared decision-making programs of the Foundation for Informed Medical Decision Making back in the ’90s, I find this interesting but not surprising. We, too, found way back then that users were often turned off by forced interactivity. And, interestingly, the first non-interactive decision aid we produced was on prostate cancer screening and it ran for 20 minutes.

You can take a look at the Prosdex decision aid here. Here’s a screen shot of the entry page:

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