An important paper in the Archives of Internal Medicine shows how the quality of the discussion men are having with their physicians about prostate cancer screening does not reflect shared decision-making. The discussion often focuses on the benefits of screening without mentioning the harms. And in fact many men weren't even asked about their preferences regarding screening.
From the paper describing the study:
The finding that 30.1% of subjects underwent PSA testing without first discussing screening... is a disconcerting finding. Only 20.6% of discussions presented both the pros and cons of screening and elicited the subject's preferences for testing.
The authors conclude:
Given the challenges of meeting these expectations in routine clinical encounters, alternative strategies, such as decision aids, need to be considered to ensure a process that engages patients in decision making, provides them with information about alternative strategies, and facilitates the incorporation of their preferences and values into the medical plan.
Disclosure: the study was funded in part by the Foundation for Informed Medical Decision Making, which supports my HealthNewsReview.org project.

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