A new analysis published in the Annals of Family Medicine,”Primary Care Physicians’ Use of an Informed Decision-Making Process for Prostate Cancer Screening,” found that 24% of primary care physicians who responded to a survey said they ordered screening without discussing it with patients.
How’s that for shared decision-making?
Fewer than 48% of those surveyed said they discussed harms and benefits with patients before letting the men decide. These doctors “were more likely to endorse beliefs that scientific evidence does not support screening, that patients should be told about the lack of evidence, and that patients have a right to know the limitations of screening; they were also less likely to endorse the belief that there was no need to educate patients because they wanted to be screened.”
(You can see the Reuters Health story on this study here. Was this the only mainstream news organization to report on this study? If so, why? )
Let me remind you of a classic case of a doctor ordering a PSA test without telling a patient. About 15 months ago, I posted a video of lawyer Tim Glynn whose doctor ordered a PSA test without telling him. His anger is still palpable 14 years after this incident. “It drove tremendous consequences for my life on a piece of information that isn’t information – it doesn’t mean anything,” he says in the video.
And let me remind you of the DECISIONS study that found that “most prostate cancer screening decisions did not meet criteria for shared decision making because subjects did not receive balanced discussions of decision consequences, had limited knowledge, and were not routinely asked for their preferences.”
The body of evidence is growing: many American men are not being provided the evidence they need to make an informed decision about prostate cancer screening. And harms may occur as a result.
Opinions on other issues in news, journals, PR, advertising, marketing
Following a shift in journalism’s business model, a diverse ecosystem of publications, many covering science, has sprung up online. This has made it more difficult to sort out what qualifies as journalism, what doesn’t, and whether the public even cares.
https://t.co/qO2a27FiSe
Researchers and journalists do the public a grave disservice when they spin health study results to make them appear safer or more effective than warranted, says @HealthNewsRevu founder @garyschwitzer https://t.co/QIKsRbP6Ed
Comments (6)
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Richard Hoffman
January 15, 2013 at 6:22 pmThat 24% of respondents, who were surveyed in 2007, failed to even discuss screening is disconcerting, especially because most contemporaneous guidelines were encouraging informed decision-making. Respondents who screened without discussion were more likely to cite time barriers and malpractice concerns. A potential strategy for overcoming these barriers would be to provide patients with decision aids. These decision support tools, which can be written, video, or web-based, have been shown to increase knowledge, reduce decisional conflict, and could also facilitate shorter, more focused clinic discussions. Furthermore, Washington State has passed legislation recognizing that using a decision aid constitutes evidence of an informed consent. The lawyer Ben Moulton (J Law Med Ethics Spring 2010) has argued that using decision aids “establishes a higher burden of proof for patients attempting to claim that they were not adequately informed of risks or alternatives.” Screening for prostate cancer is a complex, controversial, and important health decision that should be based on the preferences of an informed patient. Health care providers should engage patients in the decision-making process.
Kathy Nieder MD
January 17, 2013 at 8:11 amThis was a study of only Family Practice docs. It would be interesting to see if the Internists fair any better, though my guess is they would not.
David S. Most
January 21, 2013 at 7:40 pmIt takes a lot of time to discuss the pros and cons of screening. But absent physical symptoms in early stage CaP we only have PSA to warn a patient. Single PSA values are of limited values but PSA history built up over a few years can be of greater value. Yes, overtreatment can create morbidity. But prostate cancer untreated can cause death. Knowledge is power. Making a decision absent information is playing Russian Roulette.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like