Updated review published today on The Cochrane Library: Decision aids for people facing health treatment or screening decisions
Citation: Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu JHC. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2014 , Issue 1 . Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub4
Now 115 included studies, nearly 35,000 participants, showing decision aids improve people’s knowledge, help them feel more informed, participate more in decision making.
The Summary includes, ‘ Decision aids reduce the choice of prostate specific antigen (psa) testing and elective surgery when patients consider other options’.
My comment: the harms and lack of benefit of breast cancer screening have brought about calls for a fresh look at cost and effectiveness.
It seems to me that men with raised psa levels are likely to be sent for NHS ‘hit and miss biopsies’. These are likely to be many in number and taken via the back passage, with the obvious risk of infection. The results can be misleading.
Whereas, men who are informed may well make the choice of having an MRI scan privately. Then, if something significant shows up, far fewer biopsies can be taken and, if done privately, involve only biopsy needle insertion directly through the skin, with accuracy, less chance of infection or complications and more reliable results.