Efficacy of decision aid delivery modes in prostate cancer screening: umbrella review and network meta-analysis

IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY
Zen Yang Ang, Yuke-Lin Kong, Zarith Nameyrra Md Nesran, Shaun Wen Huey Lee
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引用次数: 0

Abstract

Objective

To review and compare the efficacy of different delivery modes of decision aids (DAs), including computer-based, print-based, multimedia-based, video-based, and website-based on decision-making outcomes for prostate cancer screening compared to usual care (UC) and among the delivery modes.

Methods

PubMed, the Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Advanced Search, and Turning Research Into Practice (TRIP) Database were systematically searched from inception to August 2023. The primary outcomes were knowledge level, knowledge scores, participation in shared decision-making (SDM), decisional conflict, and preference for SDM participation. Secondary outcomes were the proportion of subjects who underwent screening (actual screening utilisation) and the proportion of subjects who intended to be screened (intention to undergo screening). Network and pairwise meta-analyses were performed using random-effects models.

Results

Seven systematic reviews were included. Network meta-analysis found that multimedia (relative risk [RR] 1.51, 95% confidence interval [CI] 1.02–2.24), print (RR 1.82, 95% CI 1.23–2.69), and website-based (RR 1.99, 95% CI 1.32–3.01) DAs significantly increased participation in SDM compared to the computer-based DA. There was a significant reduction in the actual screening utilisation in the computer DA arm compared to the other delivery modes. No significant differences between all delivery modes were noted on knowledge levels, knowledge scores, decisional conflict, preference for SDM participation, and intention to undergo screening. The highest mean surface under the cumulative ranking curve for all primary outcomes showed that website-based was the most effective delivery mode, followed by print-based DA. The pairwise meta-analysis showed a significant increase in participants’ knowledge level, knowledge scores, a reduced intention to undergo screening and actual screening utilisation compared to UC.

Conclusions

The findings suggest that different types of DAs have varying levels of effectiveness in increasing knowledge level, knowledge scores, participation in SDM, and influencing screening behaviours. While website-based DA appeared the most effective, employing the print-based DA could be a practical solution in settings with limited resources.

Abstract Image

前列腺癌筛查中决策辅助工具提供模式的功效:总体回顾和网络荟萃分析
回顾并比较不同决策辅助工具(DAs)提供模式的效果,包括计算机型、印刷型、多媒体型、视频型和网站型,与常规护理(UC)相比以及不同提供模式之间对前列腺癌筛查决策结果的影响。
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来源期刊
BJU International
BJU International 医学-泌尿学与肾脏学
CiteScore
9.10
自引率
4.40%
发文量
262
审稿时长
1 months
期刊介绍: BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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