Evidence map›Paper›PMID 39879616›Full record

SynthesisJournal of medical Internet research2025

Impact of Online Interactive Decision Tools on Women's Decision-Making Regarding Breast Cancer Screening: Systematic Review and Meta-Analysis.

Patricia Villain, Laura Downham, Alice Le Bonniec, Charlotte Bauquier, Olena Mandrik, Tom Nadarzynski, Lorie Donelle, Raúl Murillo, Eleni L Tolma, Sonali Johnson and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Patricia VillainInternational Agency for Research on Cancer, World Health Organization, Lyon, France.ORCID https://orcid.org/0000-0002-5060-4668
Laura DownhamInternational Agency for Research on Cancer, World Health Organization, Lyon, France.ORCID https://orcid.org/0009-0001-1669-6298
Alice Le BonniecInternational Agency for Research on Cancer, World Health Organization, Lyon, France.ORCID https://orcid.org/0000-0001-9916-8038
Charlotte BauquierPôle de Psychologie Sociale, Inserm U1296, Université Lumière Lyon 2, Lyon, France.ORCID https://orcid.org/0000-0002-6021-310X
Olena MandrikSheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, United Kingdom.ORCID https://orcid.org/0000-0003-3755-3031
Tom NadarzynskiSchool of Social Sciences, University of Westminster, London, United Kingdom.ORCID https://orcid.org/0000-0001-7010-5308
Lorie DonelleCollege of Nursing, University of South Carolina, Columbia, SC, United States.ORCID https://orcid.org/0000-0001-9276-8639
Raúl MurilloCentro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogota, Colombia.ORCID https://orcid.org/0000-0001-7187-9946
Eleni L TolmaDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.ORCID https://orcid.org/0000-0002-7317-0559
Sonali JohnsonUnion for International Cancer Control, Geneva, Switzerland.ORCID https://orcid.org/0000-0001-8673-9540
Patricia Soler-MichelCentre Régional de Coordination des Dépistages des Cancers Auvergne-Rhône-Alpes, Site Rhône & Métropole de Lyon, Lyon, France.ORCID https://orcid.org/0000-0002-9278-5962
Robert SmithCancer Screening, American Cancer Society, Atlanta, GA, United States.ORCID https://orcid.org/0000-0003-3344-2238

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThe online nature of decision aids (DAs) and related e-tools supporting women's decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs.

objectiveThis systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy.

methodsWe followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to April 2023. We included studies reporting on populations at average risk of breast cancer, which utilized DAs or related e-tools, and assessed women's participation in BCS by mammography or other key cognitive determinants of decision-making as primary or secondary outcomes. We conducted meta-analyses on the identified randomized controlled trials, which were assessed using the revised Cochrane Risk of Bias 2 (RoB 2) tool. We further explored intermediate and high heterogeneity between studies to enhance the validity of our results.

resultsIn total, 22 different e-tools were identified across 31 papers. The degree of tailoring in the e-tools, specifically whether the tool was fully tailored or featured with tailoring, was the most influential factor in women's decision-making regarding BCS. Compared with control groups, tailored e-tools significantly increased women's long-term participation in BCS (risk ratio 1.14, 95% CI 1.07-1.23, P<.001, I

conclusionsFeatures-with-tailoring e-tools could potentially negatively impact BCS programs by fostering negative intentions and attitudes toward BCS participation. Conversely, tailored e-tools may increase women's participation in BCS but, when tailored to risk, they may elevate their levels of worry. To maximize the effectiveness of e-tools while minimizing potential negative impacts, we advocate for an "on-demand" layered approach to their design.

Indexed as

Breast NeoplasmsDecision MakingDecision Support TechniquesEarly Detection of CancerInternetFemaleHumansMammographyaverage riskbreast cancer screeningcognitive determinantsdecision aiddecision-makingonline interactivescreening participationshared decision-makingwomen

Identifiers

PMID39879616
PMCPMC11822326

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.