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Reconciling population benefits and women's individual autonomy in mammographic screening: in-depth interviews to explore women's views about 'informed choice'

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Version 1 2017-05-17, 13:37
journal contribution
posted on 2024-06-04, 11:09 authored by C Davey, Vicki WhiteVicki White, M Gattellari, JE Ward
OBJECTIVE: To explore women's reactions to 'informed choice' in mammographic screening. SETTING AND METHODS: Telephone interviews with a convenience sample of 106 women aged 45-70 years recruited from general practices in Sydney. RESULTS: Many (42%) women preferred an active role in decision-making. Respondents had low scores for 'uncertainty' and 'factors contributing to uncertainty' in response to explicit questions about the decision to have mammographic screening. Yet respondents indicated significantly greater willingness to have a test when the benefit of a 'new' screening test for breast cancer was expressed as relative risk reduction (RRR) (88%) than either absolute risk reduction (ARR) (78%) (McNemar's test: chi(2)1=7.14, p=0.013) or all-cause mortality (53%) (McNemar's test: chi(2)1=35.1, p<0.01). Significantly more respondents considered information about ARR 'new' to them (65%) compared with RRR information (30%) (McNemar's test: chi(2)1=25.83, p<0.01). CONCLUSIONS: As mammographic screening exposes well women to potential harms for an overall population benefit, it is challenging to ensure 'informed choice'. Our results suggest women will likely appreciate individual consultations as the context in which to share complex information that women in our study agreed they need to know about mammographic screening. Our results also demonstrate that women's willingness as individuals to participate in mammographic screening is influenced by 'framing effect'. Hence, the quantitative content of decision aids to promote 'informed choice' must be comprehensive and balanced.

History

Journal

Australian and New Zealand journal of public health

Volume

29

Pagination

69-77

Location

Chichester, Eng.

Open access

  • Yes

ISSN

1326-0200

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2005, [Wiley]

Issue

1

Publisher

Wiley