Trial Information

Shared Decision Making: Prostate Cancer Screening

Prostate cancer is an important cause of death and disability in US men, but the value of
screening for the disease with the prostate specific antigen (PSA) test remains highly
controversial. Many primary care physicians use PSA testing routinely, with little patient
counseling. Interventions to Improve Shared Decision-Making: Prostate Cancer Screening is a
prospective study of educational interventions to improve shared decision-making of
physicians and their patients about prostate cancer screening. Physicians will be
randomized by practice site to receive standard informational brochures (control group) or a
novel web-based interactive curriculum that provides education about prostate cancer
screening, including potential benefits and harms, fundamentals of effective patient
counsel, and shared decision-making. In addition, patients at intervention sites will be
randomized to receive either the brochure or a patient-oriented interactive curriculum
covering content similar to that contained in the physician tool. The intervention will be
evaluated among 140 physicians within a variety of primary care settings (i.e.,
University-based clinics, staff-model managed care clinics, and military affiliated
outpatient clinics). Approximately 10-15 actual patients of each participating physician
will complete a post-visit questionnaire describing their discussion with their doctor about
prostate cancer, PSA, and their decision about whether to be screened. Physicians in all
groups will also see one unannounced standardized patient (SP) trained to portray a patient
interested in discussing PSA. Study groups will be compared on the extent of shared
decision-making they engage in with both actual and standardized patients. Pre- and
post-study changes in physician knowledge and attitudes about PSA as well as the physicians'
pre- and post-study PSA test ordering rates will be ascertained.