Improving the quality of decision-making processes for prostate cancer screening: Progress and challenges
Mené sur 1 879 patients ambulatoires âgés de 45 à 70 ans, cet essai multicentrique, évalue, par rapport à une consultation médicale, l'efficacité de deux interventions, l'une utilisant un guide pédagogique, l'autre un site web interactif, pour informer les patients sur le dépistage du cancer de la prostate et les aider à prendre une décision
Guidelines recommend that patients be informed about potential benefits and harms from prostate cancer screening and that screening decisions involve a discussion between patients and their physicians.1,2 Despite this consensus, achieving high-quality decision-making processes in practice is difficult. Clinicians function in a time-constrained environment and know that ordering a prostate-specific antigen (PSA) blood test is simple, whereas ensuring that patients fully understand the potential ramifications of entering a screening program is far more difficult and time-consuming. Explaining such concepts as biopsy threshold, false-positive results, overdiagnosis, and uncertainty about magnitude of benefit is challenging and cannot be done quickly.
JAMA Internal Medicine , commentaire, 2012