Bridging the gap at the center of patient centeredness: Individual patient preferences in health care decision making: comment on “comparing 3 techniques for eliciting patient values for decision making about prostate-specific antigen screening”
Menée auprès de 911 hommes américains ou australiens d'âge compris entre 50 et 70 ans et ayant un risque moyen de cancer de la prostate, cette étude évalue différentes méthodes permettant de les aider dans la décision d'effectuer un dosage de l'antigène spécifique de la prostate
During the past decade, the importance of using individual patient values and preferences to guide cancer screening decisions has become clear, and the use of prostate-specific antigen (PSA) testing to screen for prostate cancer is a case in point.2- 4 The PSA screening decision has been known as a preference-sensitive decision, in which several alternatives exist and complex trade-offs between the risks and benefits of each alternative must be weighed in making the choice. This choice is complicated by the low sensitivity and specificity of the PSA test and by the risk of significant harms associated with screening, such as false-positive results, pain associated with biopsy, and incontinence, sexual dysfunction, and other morbidities associated with prostate cancer treatment. Not being screened for prostate cancer is an alternative currently recommended for men of all ages by the US Preventive Services Task Force, but it is associated with its own risks, including the potential for anxiety. Thus, to achieve patient-centeredness in PSA screening decisions, each man's values and preferences based on weighing these complex risks of harms and the potential benefits of PSA testing would be used to guide his choices and the health care he receives.
JAMA Internal Medicine , commentaire, 2012