A structured implicit abstraction method to evaluate whether content of counseling before prostate cancer screening is consistent with recommendations by experts. Patient Educ Couns 2009 Dec;77(3):322-7
Date
10/20/2009Pubmed ID
19837527Pubmed Central ID
PMC2787991DOI
10.1016/j.pec.2009.09.023Scopus ID
2-s2.0-70549090859 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
OBJECTIVE: To assess the content of counseling about prostate-specific antigen (PSA) screening. Guidelines recommend informed consent before screening because of concerns about benefits versus risks. As part of the professional practice standard for informed consent, clinicians should include content customarily provided by experts.
METHODS: 40 transcripts of conversations between medicine residents and standardized patients were abstracted using an instrument derived from an expert Delphi panel that ranked 10 "facts that experts believe men ought to know."
RESULTS: Transcripts contained definite criteria for an average of 1.7 facts, and either definite or partial criteria for 5.1 facts. Second- and third-year residents presented more facts than interns (p=0.01). The most common facts were "false positive PSA tests can occur" and "use of the PSA test as a screening test is controversial." There was an r=0.88 correlation between inclusion by residents and the experts' ranking.
CONCLUSION: Counseling varied but most transcripts included some expert-recommended facts. The absence of other facts could be a quality deficit or an effort to prioritize messages and lessen cognitive demands on the patient.
PRACTICE IMPLICATIONS: Clinicians should adapt counseling for each patient, but our abstraction approach may help to assess the quality of informed consent over larger populations.
Author List
Farrell MH, Chan EC, Ladouceur LK, Stein JMMESH terms used to index this publication - Major topics in bold
AdultAnalysis of Variance
Communication
Delphi Technique
Directive Counseling
Health Education
Health Knowledge, Attitudes, Practice
Humans
Male
Mass Screening
Physician-Patient Relations
Prostate-Specific Antigen
Prostatic Neoplasms