Internet Patient Decision Support

A Randomized Controlled Trial Comparing Alternative Approaches for Men Considering Prostate Cancer Screening

Medical decisions frequently involve multiple options for patients with no clear best choice. A case in point is prostate cancer screening where the benefits are uncertain and men who are diagnosed must choose from a plethora of treatment options. High-quality medical decisions are possible if patients are informed and if their choices reflect their values and outcome preferences. Decision aids are information tools that help explain the pros and cons of different treatment options to patients. In this study, the authors evaluate two Internet decision-making interventions for men considering a prostate-specific antigen (PSA) test. More than 600 men over 50 years old were recruited from Health Approval Clinic of Kaiser Permanente in San Diego and assigned to four separate study groups.

Key Findings:

  • Participants assigned to a custom-designed tool had higher quality decision-making outcomes than those assigned to credible public Web sites.
  • Participants assigned to the custom-designed aid showed the highest prostate cancer knowledge scores and the lowest decision-making conflict scores.
  • These patients also made fewer requests for PSA tests.

The authors conclude that public Web sites about prostate cancer provide less effective decision support than specially designed decision tools.

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