Dataset Information

Comparing perceived clarity of information on overdiagnosis used for breast and prostate cancer screening in England: an experimental survey.

ABSTRACT:

Objectives

'Overdiagnosis', detection of disease that would never have caused symptoms or death, is a public health concern due to possible psychological and physical harm but little is known about how best to explain it. This study evaluated public perceptions of widely used information on the concept to identify scope for improving communication methods.

Design

Experimental survey carried out by a market research company via face-to-face computer-assisted interviews.

Setting

Interviews took place in participants' homes.

Participants

2111 members of the general public in England aged 18-70 years began the survey; 1616 were eligible for analysis. National representativeness was sought via demographic quota sampling.

Interventions

Participants were allocated at random to receive a brief description of overdiagnosis derived from written information used by either the NHS Breast Screening Programme or the prostate cancer screening equivalent.

Primary and secondary outcome measures

The primary outcome was how clear the information was perceived to be (extremely/very clear vs less clear). Other measures included previous exposure to screening information, decision-making styles and demographic characteristics (eg, education). Binary logistic regression was used to assess predictors of perceived clarity.

Results

Overdiagnosis information from the BSP was more likely to be rated as more clear compared with the prostate screening equivalent (adjusted OR: 1.43, 95% CI 1.17 to 1.75; p=0.001). Participants were more likely to perceive the information as more clear if they had previously encountered similar information (OR: 1.77, 1.40 to 2.23; p<0.0005) or a screening leaflet (OR: 1.35, 1.04 to 1.74; p=0.024) or had a more 'rational' decision-making style (OR: 1.06, 1.02 to 1.11; p=0.009).

Conclusions

Overdiagnosis information from breast screening may be a useful template for communicating the concept more generally (eg, via organised campaigns). However, this information may be less well-suited to individuals who are less inclined to consider risks and benefits during decision-making.

SUBMITTER: Ghanouni A

PROVIDER: S-EPMC5629687 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Comparing perceived clarity of information on overdiagnosis used for breast and prostate cancer screening in England: an experimental survey.

Ghanouni Alex A Renzi Cristina C McBride Emily E Waller Jo J

BMJ open 20170821 8

<h4>Objectives</h4>'Overdiagnosis', detection of disease that would never have caused symptoms or death, is a public health concern due to possible psychological and physical harm but little is known about how best to explain it. This study evaluated public perceptions of widely used information on the concept to identify scope for improving communication methods.<h4>Design</h4>Experimental survey carried out by a market research company via face-to-face computer-assisted interviews.<h4>Setting< ...[more]

PMID: 28827249

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Project description:Background. Overdiagnosis is an accepted harm of cancer screening, but studies of prostate cancer screening decision aids have not examined provision of information important in communicating the risk of overdiagnosis, including overdiagnosis frequency, competing mortality risk, and the high prevalence of indolent cancers in the population. Methods. We undertook a comprehensive review of all publicly available decision aids for prostate cancer screening, published in (or translated to) the English language, without date restrictions. We included all decision aids from a recent systematic review and screened excluded studies to identify further relevant decision aids. We used a Google search to identify further decision aids not published in peer reviewed medical literature. Two reviewers independently screened the decision aids and extracted information on communication of overdiagnosis. Disagreements were resolved through discussion or by consulting a third author. Results. Forty-one decision aids were included out of the 80 records identified through the search. Most decision aids (n = 32, 79%) did not use the term overdiagnosis but included a description of it (n = 38, 92%). Few (n = 7, 17%) reported the frequency of overdiagnosis. Little more than half presented the benefits of prostate cancer screening before the harms (n = 22, 54%) and only 16, (39%) presented information on competing risks of mortality. Only 2 (n = 2, 5%) reported the prevalence of undiagnosed prostate cancer in the general population. Conclusion. Most patient decision aids for prostate cancer screening lacked important information on overdiagnosis. Specific guidance is needed on how to communicate the risks of overdiagnosis in decision aids, including appropriate content, terminology and graphical display.HighlightsMost patient decision aids for prostate cancer screening lacks important information on overdiagnosis.Specific guidance is needed on how to communicate the risks of overdiagnosis.

Project description:BackgroundDespite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.MethodsWe conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions.FindingsOur sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity.ConclusionsA small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.

Project description:ObjectivesCommunicating the concept of 'overdiagnosis' to lay individuals is challenging, partly because the term itself is confusing. This study tested whether alternative descriptive labels may be more appropriate.DesignQuestionnaire preceded by a description of overdiagnosis.SettingHome-based, computer-assisted face-to-face survey.Participants2111 adults aged 18-70 years in England recruited using random location sampling by a survey company. Data from 1888 participants were analysed after exclusions due to missing data.InterventionsParticipants were given one of two pieces of text describing overdiagnosis, allocated at random, adapted from National Health Service breast and prostate cancer screening leaflets.Primary and secondary outcome measuresMain outcomes were which of several available terms (eg, 'overdetection') participants had previously encountered and which they endorsed as applicable labels for the concept described. Demographics and previous exposure to screening information were also measured. Main outcomes were summarised with descriptive statistics. Predictors of previously encountering at least one term, or endorsing at least one as making sense, were assessed using binary logistic regression.Results58.0% of participants had not encountered any suggested term; 44.0% did not endorse any as applicable labels. No term was notably familiar; the proportion of participants who had previously encountered each term ranged from 15.9% to 28.3%. Each term was only endorsed as applicable by a minority (range: 27.6% to 40.4%). Notable predictors of familiarity included education, age and ethnicity; participants were less likely to have encountered terms if they were older, not white British or had less education. Findings were similar for both pieces of information.ConclusionsFamiliarity with suggested terms for overdiagnosis and levels of endorsement were low, and no clear alternative labels for the concept were identified, suggesting that changing terminology alone would do little to improve understanding, particularly for some population groups. Explicit descriptions may be more effective.

Project description:Veterinarians are encouraged to use evidence to inform their practice, but it is unknown what resources (e.g. journals, electronic sources) are accessed by them globally. Understanding the key places veterinarians seek information can inform where new clinically relevant evidence should most effectively be placed. An international survey was conducted to gain understanding of how veterinary information is accessed by veterinarians worldwide. There were 2137 useable responses to the questionnaire from veterinarians in 78 countries. The majority of respondents (n = 1835/2137, 85.9%) undertook clinical work and worked in a high income country (n = 1576/1762, 89.4%). Respondents heard about the survey via national veterinary organisations or regulatory bodies (31.5%), online veterinary forums and websites (22.7%), regional, discipline-based or international veterinary organisations (22.7%) or by direct invitation from the researchers or via friends, colleagues or social media (7.6%). Clinicians and non-clinicians reportedly used journals most commonly (65.8%, n = 1207/1835; 75.6%, n = 216/286) followed by electronic resources (58.7%, n = 1077/1835; 55.9%, n = 160/286), respectively. Respondents listed a total of 518 journals and 567 electronic sources that they read. Differences in veterinarian preference for resources in developed, and developing countries, were found. The nominated journals most read were the Journal of the American Veterinary Medical Association (12.7% of nominations) for clinicians and the Veterinary Record (5.7%) for non-clinicians. The most accessed electronic resource reported was the Veterinary Information Network (25.6%) for clinicians and PubMed (7.4%) for non-clinicians. In conclusion, a wide array of journals and electronic resources appear to be accessed by veterinarians worldwide. Veterinary organisations appear to play an important role in global communication and outreach to veterinarians and consideration should be given to how these channels could be best utilised for effective dissemination of key research findings.

Dataset Information

Comparing perceived clarity of information on overdiagnosis used for breast and prostate cancer screening in England: an experimental survey.

Objectives

Design

Setting

Participants

Interventions

Primary and secondary outcome measures

Results

Conclusions

Publications

Comparing perceived clarity of information on overdiagnosis used for breast and prostate cancer screening in England: an experimental survey.

Similar Datasets

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