PMID- 25666221
OWN - NLM
STAT- MEDLINE
DCOM- 20160308
LR  - 20220309
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 30
IP  - 6
DP  - 2015 Jun
TI  - A Randomized Controlled Effectiveness Trial for PSA Screening Decision Support 
      Interventions in Two Primary Care Settings.
PG  - 810-6
LID - 10.1007/s11606-015-3214-9 [doi]
AB  - BACKGROUND: Decision support interventions (DESIs) provide a mechanism to 
      translate comparative effectiveness research results into clinical care so that 
      patients are able to make informed decisions. Patient decision support 
      interventions for prostate-specific antigen (PSA) have been shown to promote 
      informed decision making and reduce PSA testing in efficacy trials, but their 
      impact in real world settings is not clear. OBJECTIVE: We performed an 
      effectiveness trial of PSA decision support interventions in primary care. 
      DESIGN: A randomized controlled trial of three distribution strategies was 
      compared to a control. PARTICIPANTS: Participants included 2,550 men eligible for 
      PSA testing (76.6 % of the eligible population) and 2001 survey respondents (60.1 
      % survey response rate). INTERVENTIONS: The intervention groups were: 1) mailed 
      the DESI in DVD format, 2) offered a shared medical appointment (SMA) to view the 
      DESI with other men and discuss, and 3) both options. MAIN MEASURES: We measured 
      PSA testing identified via electronic medical record at 12 months and DESI use by 
      self-report 4 months after the intervention mailing. KEY RESULTS: We found no 
      differences in PSA testing across the three distribution strategies over a 
      year-long follow-up period: 21 %, 24 %, 22 % in the DESI, SMA, and combined group 
      respectively, compared to 21 % in the control group (p = 0.51). Self-reported 
      DESI use was low across all strategies at 4 months: 16 % in the mailed DESI 
      group, 6 % in the SMA group, and 15 % in the combined group (p = < 0.0001). 
      CONCLUSIONS: Mailing PSA decision support interventions or inviting men to shared 
      medical appointments unrelated to a primary care office visit do not appear to 
      promote informed decision making, or change PSA testing behavior.
FAU - Lewis, Carmen L
AU  - Lewis CL
AD  - Division of General Internal Medicine, Department of Medicine, University of 
      Colorado School of Medicine, Mail stop B180, Academic Office 1, Room 8415, 12631 
      E 17th Ave, Aurora, CO, 80045, USA, Carmen.L.Lewis@ucdenver.edu.
FAU - Adams, Jared
AU  - Adams J
FAU - Tai-Seale, Ming
AU  - Tai-Seale M
FAU - Huang, Qiwen
AU  - Huang Q
FAU - Knowles, Sarah B
AU  - Knowles SB
FAU - Nielsen, Matthew E
AU  - Nielsen ME
FAU - Pignone, Michael P
AU  - Pignone MP
FAU - Walter, Louise C
AU  - Walter LC
FAU - Frosch, Dominick L
AU  - Frosch DL
LA  - eng
SI  - ClinicalTrials.gov/NCT01241656
GR  - K24 AG041180/AG/NIA NIH HHS/United States
GR  - R01 CA134425/CA/NCI NIH HHS/United States
GR  - R01 CA1334425-01/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20150210
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
RN  - EC 3.4.21.- (KLK3 protein, human)
RN  - EC 3.4.21.- (Kallikreins)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
CIN - Evid Based Med. 2015 Aug;20(4):139. PMID: 26041793
MH  - Aged
MH  - *Decision Support Techniques
MH  - Early Detection of Cancer/methods
MH  - Humans
MH  - Kallikreins/*blood
MH  - Male
MH  - Middle Aged
MH  - *Primary Health Care
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*diagnosis
PMC - PMC4441669
EDAT- 2015/02/11 06:00
MHDA- 2016/03/10 06:00
PMCR- 2016/06/01
CRDT- 2015/02/11 06:00
PHST- 2014/08/20 00:00 [received]
PHST- 2015/01/23 00:00 [accepted]
PHST- 2015/01/12 00:00 [revised]
PHST- 2015/02/11 06:00 [entrez]
PHST- 2015/02/11 06:00 [pubmed]
PHST- 2016/03/10 06:00 [medline]
PHST- 2016/06/01 00:00 [pmc-release]
AID - 3214 [pii]
AID - 10.1007/s11606-015-3214-9 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2015 Jun;30(6):810-6. doi: 10.1007/s11606-015-3214-9. Epub 2015 
      Feb 10.