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Randomised controlled trial
Delivering a decision support intervention about PSA screening to patients outside of clinical encounters is ineffective in promoting informed decision-making
  1. Paul K J Han
  1. Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine, USA
  1. Correspondence to Dr Paul K J Han, Center for Outcomes Research and Evaluation, Maine Medical Center, 509 Forest Avenue, Portland, ME 04101, USA; hanp{at}mmc.org

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Context

Prostate-specific antigen (PSA) screening is a commonly utilised but controversial intervention of uncertain clinical value. Major professional organisations have therefore recommended that patients be fully informed about the pros, cons, and uncertainties of PSA screening, and enabled to decide based on their own values—a process known as informed decision-making (IDM).1 The US Preventive Services Task Force and other influential groups have further highlighted the need for shared decision-making (SDM)—the collaborative engagement of clinicians in this process.2 Nevertheless, IDM and SDM have not been the norm in clinical practice.

Well-known barriers to IDM and SDM include limited clinical time and resources for these efforts. Patient decision …

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