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HEALTH CARE REFORM
Shared Decision Making for Prostate Cancer ScreeningDo Patients or Clinicians Have a Choice?
Steven H. Woolf, MD, MPH;
Alex Krist, MD, MPH
Arch Intern Med. 2009;169(17):1557-1559.
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The prostate-specific antigen (PSA) test was introduced in the late 1980s. Twenty years later there remains inadequate evidence about its benefits and harms when used for screening. The seriousness of the disease is unquestioned—prostate cancer claimed an estimated 28 660 lives in 20081—and the human toll impels the public, clinicians, and the public health community to act. However, evidence that early detection improves outcomes is scant, the often latent forms of the disease may pose little clinical threat to patients, false-positive results are common, and the harms and downstream consequences may outweigh the benefits.
THE RATIONALE FOR SHARED DECISION MAKING
The uncertain trade-offs and scant data have been the recurring concern of the US Preventive Services Task Force (USPSTF), which since 1989 has maintained that the evidence is insufficient to recommend for or against prostate cancer screening. (For men 75 years and older, the USPSTF has found . . . [Full Text of this Article]
SHARED DECISION MAKING IN PRACTICE
THE CHALLENGES TO SHARED DECISION MAKING
AUTHOR INFORMATION
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Richard M. Hoffman, Mick P. Couper, Brian J. Zikmund-Fisher, Carrie A. Levin, Mary McNaughton-Collins, Deborah L. Helitzer, John VanHoewyk, and Michael J. Barry
Arch Intern Med. 2009;169(17):1611-1618.
ABSTRACT
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