ArticleJournal of the American Geriatrics Society2025
Creating a Mammography Conversation Aid for Shared Decision-Making Between Clinicians and Women Aged 75 and Older.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Does Messaging for Reducing Breast Cancer Overscreening in Older Women Have Differential Responses among Medical Minimizers and Maximizers?Medical decision making : an international journal of the Society for Medical Decision Making · 2026Trial
- Clinical and sociodemographic characteristics associated with health-related quality of life among older breast cancer survivors.Women's health (London, England)Article
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Authors and funding
16 authors.
Funding
Abstract
backgroundGuidelines recommend primary care practitioners ("PCPs") engage women ≥ 75 years in shared decision-making (SDM) around mammography screening. Therefore, we aimed to develop a web-based conversation aid about mammography screening for women ≥ 75 using output from established simulation models to provide screening outcomes based on > 23,000 combinations of individual women's health and breast cancer risk factors.
methodsWe used an end-user centered design approach to develop a prototype web-based conversation aid incorporating feedback. From July 2023 to April 2024, 10 PCPs from a Boston-area health system and a safety-net hospital used the prototype aid during encounters with women ≥ 75 without breast cancer or dementia (n = 30; 1-5 patients per PCP). We observed aid use and assessed clinician effort to involve patients in SDM using OPTION5 (assesses five components of SDM, scores range 0-100). We surveyed PCPs and patients about the aid's acceptability. Patients completed the SDM-process scale (scores range 0-4) to rate the SDM quality experienced. Participants' comments were subject to thematic analysis.
resultsOf 10 PCP-participants, seven were female and four were community-based. Of 30 patient-participants, 22 (73%) were non-Hispanic White, 9 (30%) had ≥ 2 Charlson comorbidities and mean age was 78.5 years (SD 2.8). Nine PCPs agreed that the aid helped them with SDM and was easy-to-use; six felt it had too much information; and seven planned to continue using the aid. Patients rated the SDM-process highly (scores = 3.0 [SD 0.9]) and we observed high SDM (mean OPTION5 = 77.9 [SD 20.6]). Participants felt the aid was "empowering" and "helpful for decision-making." After SDM discussions, seven patients intended to stop screening, nine to screen less frequently, and 14 to continue screening regularly.
conclusionsWe developed a novel conversation aid that supports SDM about mammography screening with women ≥ 75 years. Lessons learned will guide revisions of a final tool for testing in a clinical trial.
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