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Introduction: We aimed to develop a decision aid to support shared-decision making between physicians and women with average breast cancer risk when deciding whether to participate in breast cancer screening., Methods: We included women at average risk of breast cancer and physicians involved in supporting the decision of breast cancer screening from an Academic Hospital in Buenos Aires, Argentina. We followed the International Patient Decision Aid Standards to develop our decision aid. Guided by a steering group and a multidisciplinary consultancy group including a patient advocate, we reviewed the evidence about breast cancer screening and previous decision aids, explored the patients' information needs on this topic from the patients' and physicians' perspective using semi-structured interviews, and we alpha-tested the prototype to determine its usability, comprehensibility and applicability., Results: We developed the first prototype of a web-based decision aid to use during the clinical encounter with women aged 40 to 69 with average breast cancer risk. After a meeting with our consultancy group, we developed a second prototype that underwent alpha-testing. Physicians and patients agreed that the tool was clear, useful and applicable during a clinical encounter. We refined our final prototype according to their feedback., Conclusion: We developed the first decision aid in our region and language on this topic, developed with end-users' input and informed by the best available evidence. We expect this decision aid to help women and physicians make shared decisions during the clinical encounter when talking about breast cancer screening., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Objectives: To quantitatively document the degree of compliance of institutional messages broadcast on social networks with the recommendations of the National Cancer Institute (INC) in Argentina during October 2019, in the context of breast cancer prevention campaigns, and to qualitatively analyze the pictorial and textual elements that make up their dissemination pieces., Materials and Methods: Quantitative and qualitative analysis of 171 dissemination pieces issued during October 2019 by 54 institutions, based on the evaluation of their compliance with INC recommendations, the description of the main discordant recommendations (quantitative analysis) and the qualitative analysis of 30 pieces., Results: None of the issued messages mentioned potential screening harms. Only the messages of the National Ministry of Health complied completely with the INC recommendations, while the remaining ones recommended mammograms at younger ages or at shorter intervals. Breast self-examination was the most frequent recommendation among those who didn't comply. The images of female bodies linked to common stereotypes of sex and beauty, and paternalistic discourses appealing to fear and guilt were predominant., Conclusions: The messages broadcasted in the analyzed diffusion pieces did not comply with the INC recommendations, despite the fact that the latter are supported by scientific evidence. On the other hand, the messages reinforce sex and beauty stereotypes, guilt and the medical-hegemonic model.

Background: Although prostate cancer (PC) screening with prostate-specific antigen (PSA) determination could decrease mortality, concerns about the potential risk of overdiagnosis led to recommendations against this preventive practice. The objective of this study was to describe the trend in PSA determinations in men between 40 and 79 years old, affiliated to a Health Maintenance Organization (HMO) of an academic hospital in the city of Buenos Aires, Argentina, and its association with the recommendations stated by the U.S. Preventive Task Force (USPSTF) and the Instituto Nacional del Cáncer in Argentina., Methods: We analyzed a time series of aggregated data. We calculated the annual age-standardized rates of accumulated determinations of PSA for every 100 affiliates without a personal history of PC. Additionally, we compared trends by age groups every 10 years. We used Joinpoint and MS Excel programs., Results: Between 2006 and 2011 there was a growing trend in the number of PSA determinations, with an annual average of + 1.2% (95% CI, -1.0 to +3.5). Between 2011 and 2015, the number of determinations began to decrease, with a percentage annual average of -4.1% (-6.9 to -1.1)., Conclusion: We found a gradual decrease in PSA utilization in men between 40 and 79 years old after the 2012 USPSTF recommendation against prostate cancer screening., (Universidad Nacional de Córdoba)

Objective: To translate, transcultural adapt, and validate the "CollaboRATE" measure and the "Ask 3 Questions" intervention in Argentina, allowing us to quantify the degree of use and implementation of shared decision making (SDM)., Design: Cross-sectional study., Setting and Participants: Data were collected in an academic hospital in Buenos Aires. Physician-patient pairs were invited to participate following their scheduled outpatient visits., Measurements: Two processes were carried out as follows: (a) The translation and transcultural adaptation process, in which translations were produced and then adapted to Spanish. (b) The validation process, in which questionnaires were completed by patient-physician pairs, the results of which were subsequently analysed. Reliability (Cronbach's alpha) and construct validity (principal component analysis) were assessed., Results: The final Spanish versions of "CollaboRATE" and "Ask 3 Questions" were tested in a primary care sample of 56 participants. Both instruments presented adequate reliability and validity. Internal consistency yielded a Cronbach's alpha of 98.3 for the "CollaboRATE" measure and 0.77 and 0.69 for the patients and physicians versions of the "Ask 3 Questions" intervention. Principal components analysis showed eigenvalues of first component >1., Discussion and Conclusions: We obtained valid and reliable Spanish versions of the "CollaboRATE" measure and the "Ask 3 Questions" intervention. These versions can be used for the assessment of SDM in clinical visits, and to obtain new information which could help the monitoring of its implementation., (© 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Objectives: The objective of this study is to describe the frequency and type of medication discrepancies (MD) through medication reconciliation and to describe the frequency of potentially inadequate prescription (PIP) medications using screening tool of older persons' prescriptions criteria., Design: Cross-sectional comparison of electronic medical record (EMR) medication lists and patient's self-report of their comprehensive medication histories obtained through telephone interviews., Inclusion Criteria: Elderly individuals (>65 years old) with more than ten medications recorded in their EMR, who had not been hospitalized in the past year and were not under domiciliary care, affiliated to a private community hospital., Outcome Measures: The primary outcomes were the proportion of patients with MD and PIP. Secondary outcomes were the proportion of types of discrepancies and PIP. We analyzed possible associations between these variables and other demographic and clinical variables., Results: Out of 214 randomly selected individuals, 150 accepted to participate (70%). The mean number of medications referred to be consumed by patients was 9.1 (95% confidence interval [CI] =8.6-9.6), and the mean number of prescribed medications in their EMR was 13.9 (95% CI = 13.3-14.5). Ninety-nine percent had at least one discrepancy (total 1252 discrepancies); 46% consumed at least one prescription not documented in their EMR and 93% did not consume at least one of the prescriptions documented in their EMR. In 77% of the patients, a PIP was detected (total 186), 87% of them were at least within one of the following categories: Prolonged used of benzodiazepines or proton pump inhibitors and the use of aspirin for the primary prevention of cardiovascular disease., Conclusions: There was a high prevalence of MD and PIP within the community of elderly adults affiliated to a Private University Hospital. Future interventions should be aimed at reducing the number of PIP to prevent adverse drug events and improve EMR accuracy by lowering medications discrepancies., Competing Interests: There are no conflicts of interest.

Overuse of osteoporosis screening in women at low risk of fracture may lead to overdiagnosis, inappropriate treatment and medicalization. The objective of this work was to estimate the proportion of women aged 45 to 64 enrolled in a private health insurance plan in Buenos Aires undergoing hip dual-energy x-ray absorptiometry (DXA) in 2011 without meeting osteoporosis screening criteria. In this cross-sectional study, 4310 women of this age range that had undergone a hip DXA were identified. A randomly selected sub-group of 401 women was then assessed for the presence of risk factors for osteoporosis and complete data were retrieved for 178 women. Appropriate screening was defined by two criteria: 1) having a 10-year fracture risk higher than that of a 65-year old woman (estimated using the FRAX® tool); 2) having at least one risk factor for fracture. It was found that 86.5% of the women who underwent hip DXA did not exceed the minimum 10-year fracture risk threshold required for screening; 5.8% of them had osteoporosis and 61.0% osteopenia. According to the second criterion, 49.4% had no risk factors, 3.4% of these women had osteoporosis and 62.5% osteopenia. The results show that at least half the women screened did not meet osteoporosis screening criteria.