--- title: "RCT for PSA screening decision support interventions. | Sutter Health" description: "Mailing PSA decision support interventions or inviting men to shared medical appointments unrelated to a primary care office visit do not appear to promote informed decision making, or change PSA testing behavior." url: "https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. RCT for PSA screening decision support interventions. # A randomized controlled effectiveness trial for PSA screening decision support interventions in two primary care settings. Lewis CL, Adams J, Tai-Seale M, Huang Q, Knowles SB, Nielsen ME, Pignone MP, Walter LC, & Frosch DL. _J Gen Intern Med. 2015 Jun;30(6):810-6. doi: 10.1007/s11606-015-3214-9. Epub 2015 Feb 10._ 2015-02-10 ## Abstract BACKGROUND: Decision support interventions (DESIs) provide a mechanism to translate comparative effectiveness research results into clinical care so that patients are able to make informed decisions. Patient decision support interventions for prostate-specific antigen (PSA) have been shown to promote informed decision making and reduce PSA testing in efficacy trials, but their impact in real world settings is not clear. OBJECTIVE: We performed an effectiveness trial of PSA decision support interventions in primary care. DESIGN: A randomized controlled trial of three distribution strategies was compared to a control. PARTICIPANTS: Participants included 2,550 men eligible for PSA testing (76.6 % of the eligible population) and 2001 survey respondents (60.1 % survey response rate). INTERVENTIONS: The intervention groups were: 1) mailed the DESI in DVD format, 2) offered a shared medical appointment (SMA) to view the DESI with other men and discuss, and 3) both options. MAIN MEASURES: We measured PSA testing identified via electronic medical record at 12 months and DESI use by self-report 4 months after the intervention mailing. KEY RESULTS: We found no differences in PSA testing across the three distribution strategies over a year-long follow-up period: 21 %, 24 %, 22 % in the DESI, SMA, and combined group respectively, compared to 21 % in the control group (p = 0.51). Self-reported DESI use was low across all strategies at 4 months: 16 % in the mailed DESI group, 6 % in the SMA group, and 15 % in the combined group (p = < 0.0001). CONCLUSIONS: Mailing PSA decision support interventions or inviting men to shared medical appointments unrelated to a primary care office visit do not appear to promote informed decision making, or change PSA testing behavior. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/25666221) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Men's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Men%27s+Health%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Engaging patients in decisions about cancer screening: exploring the decision journey through the use of a patient portal.](https://www.sutterhealth.org/research/publications/cancer-screening-decisions-pt-portal-1055312320) Woolf SH, Krist AH, Lafata JE, Jones RM, Lehman RR, Hochheimer CJ, Sabo RT, Frosch DL, Zikmund-Fisher BJ, Longo DR. Am J Prev Med. pii: S0749-3797(17)30650-5. doi: 10.1016/j.amepre.2017.10.027. \[Epub ahead of print\] 2017 Dec 11 - Publication ### [Virtual small groups for weight management: an innovative delivery mechanism for evidence-based lifestyle interventions among obese men.](https://www.sutterhealth.org/research/publications/virtual-small-groups-weight-mgmt-in-obese-men-1055312966) Azar KM, Aurora M, Wang EJ, Muzaffar A, Pressman A, Palaniappan LP. Transl Behav Med. 5(1):37-44. doi: 10.1007/s13142-014-0296-6. 2015 Mar 01 - Publication ### [Frontline perspectives on physician burnout and strategies to improve well-being: interviews with physicians and health system leaders.](https://www.sutterhealth.org/research/publications/strategies-to-improve-physician-burnout-1055312678) Dillon EC, Tai-Seale M, Meehan A, Martin V, Nordgren R, Lee T, Nauenberg T, Frosch DL. J Gen Intern Med. doi: 10.1007/s11606-019-05381-0. \[Epub ahead of print\] 2019 Oct 28 - Publication ### [The chronic care model and relationships to patient health status and health-related quality of life.](https://www.sutterhealth.org/research/publications/chronic-care-model-pt-health-status-qol-1055312441) Hung DY, Glasgow RE, Dickinson LM, Froshaug DB, Fernald DH, Balasubramanian BA, Green LA. Am J Prev Med. 35(5 Suppl):S398-406. doi: 10.1016/j.amepre.2008.08.009. 2008 Nov 01 - Publication ### [Prioritization of evidence-based preventive health services during periodic health examinations.](https://www.sutterhealth.org/research/publications/priority-of-preventive-health-services-in-visits-1055312580) Shires DA, Stange KC, Divine G, Ratliff S, Vashi R, Tai-Seale M, Lafata JE. Am J Prev Med. 42(2):164-73. doi: 10.1016/j.amepre.2011.10.008. 2012 Feb 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"RCT for PSA screening decision support interventions."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937#medicalscholarlyarticle","name":"A randomized controlled effectiveness trial for PSA screening decision support interventions in two primary care settings.","headline":"RCT for PSA screening decision support interventions.","abstract":"BACKGROUND: Decision support interventions (DESIs) provide a mechanism to translate comparative effectiveness research results into clinical care so that patients are able to make informed decisions. Patient decision support interventions for prostate-specific antigen (PSA) have been shown to promote informed decision making and reduce PSA testing in efficacy trials, but their impact in real world settings is not clear. OBJECTIVE: We performed an effectiveness trial of PSA decision support interventions in primary care. DESIGN: A randomized controlled trial of three distribution strategies was compared to a control. PARTICIPANTS: Participants included 2,550 men eligible for PSA testing (76.6 % of the eligible population) and 2001 survey respondents (60.1 % survey response rate). INTERVENTIONS: The intervention groups were: 1) mailed the DESI in DVD format, 2) offered a shared medical appointment (SMA) to view the DESI with other men and discuss, and 3) both options. MAIN MEASURES: We measured PSA testing identified via electronic medical record at 12 months and DESI use by self-report 4 months after the intervention mailing. KEY RESULTS: We found no differences in PSA testing across the three distribution strategies over a year-long follow-up period: 21 %, 24 %, 22 % in the DESI, SMA, and combined group respectively, compared to 21 % in the control group (p = 0.51). Self-reported DESI use was low across all strategies at 4 months: 16 % in the mailed DESI group, 6 % in the SMA group, and 15 % in the combined group (p = \u003c 0.0001). CONCLUSIONS: Mailing PSA decision support interventions or inviting men to shared medical appointments unrelated to a primary care office visit do not appear to promote informed decision making, or change PSA testing behavior.","description":"Mailing PSA decision support interventions or inviting men to shared medical appointments unrelated to a primary care office visit do not appear to promote informed decision making, or change PSA testing behavior.","keywords":["All Cancer","Health Services","Men's Health","Prevention and Health Maintenance"],"datePublished":"2015-02-10","url":"https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"25666221"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1007/s11606-015-3214-9"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/25666221/","https://doi.org/10.1007/s11606-015-3214-9"],"isPartOf":{"@type":"Periodical","name":"J Gen Intern Med"},"author":[{"@type":"Person","name":"Lewis CL"},{"@type":"Person","name":"Adams J"},{"@type":"Person","name":"Tai-Seale M"},{"@type":"Person","name":"Huang Q"},{"@type":"Person","name":"Knowles SB"},{"@type":"Person","name":"Nielsen ME"},{"@type":"Person","name":"Pignone MP"},{"@type":"Person","name":"Walter LC"},{"@type":"Person","name":"Frosch DL"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Men's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Men%27s+Health%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Prevention and Health Maintenance","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Prevention+and+Health+Maintenance%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/rct-psa-screening-decision-support-interventions-1055312937#breadcrumblist"}}} ```