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Adult Patients' Perspectives on the Benefits and Harms of Overused Screening Tests: a Qualitative Study.
- Source :
- JGIM: Journal of General Internal Medicine; Nov2015, Vol. 30 Issue 11, p1618-1626, 9p
- Publication Year :
- 2015
-
Abstract
- <bold>Background: </bold>In recent years, there has been a growing interest in reducing the overuse of healthcare services. However, little is known about how patients conceptualize the benefits and harms of overused screening tests or how patients make decisions regarding these tests.<bold>Objective: </bold>To determine how patients think about the harms and benefits of overused screening tests and how they consider these and other factors when making decisions.<bold>Design: </bold>Semi-structured, qualitative interviews.<bold>Participants: </bold>The study comprised 50 patients, ages 50-84, who had previously received or not received any of four overused screening services: 1) prostate cancer screening (men ages 50-69), 2) colon cancer screening (men and women ages 76-85), 3) osteoporosis screening (low-risk women ages 50-64), or 4) cardiovascular disease screening (low-risk men and women ages 50-85).<bold>Approach: </bold>We conducted a thematic analysis, using a hybrid inductive-deductive approach. Two independent coders analyzed interview transcriptions to identify themes and exemplifying quotes.<bold>Key Results: </bold>Many patients could not name a harm of screening. When they did name harms, patients often focused on only the harms of the screening test itself and rarely mentioned harms further along the screening cascade (e.g., from follow-up testing and treatment). In contrast, patients could easily name benefits of screening, although many seemed to misunderstand or overestimate the magnitude of the benefits. Furthermore, patients described many additional factors they considered when making screening decisions, including their clinicians' recommendations, their age, family or friends' experiences with disease, and insurance coverage.<bold>Conclusions: </bold>This study highlights the need to help adults recognize and understand the benefits and harms of screening and make appropriate decisions about overused screening tests. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL screening
MEDICAL decision making
CANCER diagnosis
CANCER patients
MEDICAL care
QUALITATIVE research
PATIENT education
CARDIOVASCULAR disease diagnosis
OSTEOPOROSIS diagnosis
COLON tumors
PROSTATE tumors
COMPARATIVE studies
DECISION making
HEALTH attitudes
RESEARCH methodology
MEDICAL cooperation
PRIMARY health care
RESEARCH
EVALUATION research
UNNECESSARY surgery
RANDOMIZED controlled trials
EARLY detection of cancer
PSYCHOLOGY
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 08848734
- Volume :
- 30
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- JGIM: Journal of General Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 110525369
- Full Text :
- https://doi.org/10.1007/s11606-015-3283-9