- A mammography decision aid describing the benefits and harms of mammography for women age ≥75 years in primary care leads to about 9% fewer being screened.
Why this matters
- Guidelines recommend that women age ≥75 years make informed decisions and not undergo screening if life expectancy is
- Still, many women with shorter life expectancy are screened.
- The current results suggest that this aid mitigates overscreening.
- Cluster randomized trial with primary care provider (PCP) as the unit of randomization.
- 546 women in 11 US primary care practices.
- Before a PCP visit, women received a paper-based mammography screening decision aid (DA) laying out screening benefits and harms, or a home safety pamphlet (control).
- Funding: NIH.
- After 18 months, 51.3% in the intervention group vs 60.4% of controls had undergone mammography;
- Adjusted risk ratio: 0.84 (P=.006).
- The DA group was more likely than the control group:
- To rate screening intentions as lower from pre- to postvisit (adjusted probabilities, 24.5% vs 15.3%);
- To be more knowledgeable about screening benefits/harms (adjusted probabilities, 25.5% vs 11.7%); and
- To have a documented discussion with their PCP about mammography (adjusted probabilities, 47.4% vs 38.9%).
- May not be nationally representative.