Article
This is no decision aid. It makes decision difficult.' An evidence based lay information on prostate cancer screening: The gap between methods and needs
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Published: | July 10, 2012 |
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Background: The evidence for prostate cancer (PCa) screening suggests that it may reduce PCa mortality but it certainly leads to overtreatment. The German evidence based guideline on PCa gives no recommendation for or against screening stating that the individual decision should be informed by the available evidence.
Objectives: To assess whether lay information meet the needs of consumers facing PCa screening decisions.
Methods: In the German Guideline Program in Oncology, lay versions of CPGs are mandatory. These adhere to strict quality standards. Before publication, the information on PCa screening underwent a public consultation procedure. Consumers and experts were invited to comment on the draft with a structured questionnaire.
Results: We received 62 comments from experts (69%) and 28 from consumers (31%). Methodological quality was assessed high (43%) or very high (57%) with no difference between the two groups. Experts asked for more detailed information on study quality (65%), harms of potential treatment (63%) and statistics (37%) and thought the potential effect of screening was described too positively (54%). Consumers wanted for clear recommendations for or against screening (31%), criticised the complexity of information (28%). Interestingly, healthy men as well as PCa patients stated that the benefit of one life saved outweighed the risk of overtreatment (23%).
Discussion: Consumers' perceptions of potential harms and benefits differ from experts'. A gap that cannot be bridged is the wish for clear recommendations even when the evidence is weak.
Implications for guideline developers/users: To be aware of consumers' needs when formulating communication standards.