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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
A Videotape-Based Decision Aid for Colon Cancer Screening
21 November 2000 | Volume 133 Issue 10 | Page S-50
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.
The summary below is from the full report titled "Videotape-Based Decision Aid for Colon Cancer Screening. A Randomized, Controlled Trial." It is in the 21 November 2000 issue of Annals of Internal Medicine (volume 133, pages 761-769). The authors are M Pignone, R Harris, and L Kinsinger.
What is the problem and what is known about it so far?
Colon cancer is the second leading cause of cancer deaths in the United States. Screening prevents some cases of colon cancer by detecting abnormal growths in the colon (polyps) before they become cancers and by detecting cancers in their early stages, when they can be cured. Experts recommend colon cancer screening for adults older than 50 years of age. However, fewer than one third of adults get screened for colon cancer.
Why did the researchers do this particular study?
To see whether a patient-focused, videotape-based decision aid would increase the number of patients who get colon cancer screening.
Who was studied?
The study included 249 patients (50 to 75 years of age) who had appointments with doctors in one of three primary care practices in North Carolina. To be in the study, patients had to have no personal or family history of colon cancer and no recent colon cancer screening.
How was the study done?
The researchers randomly assigned patients to one of two situations. 1) Before the visit, patients watched an 11-minute video about colon cancer screening. Patients then chose an educational pamphlet that matched their level of interest in screening. Patients with no interest in screening got a red pamphlet, those with possible interest in future screening got a yellow pamphlet, and those willing to arrange screening right away got a green pamphlet. A card that indicated patients' interest in screening was placed on the patients' charts before patients went in to see their doctors. 2) Control patients watched a video of similar length on car safety and received a pamphlet on car safety before they saw their doctors. No cards were attached to their charts. After the visit, researchers asked all study patients whether colon cancer screening had been ordered. They reviewed patients' charts to see whether patients had a colon cancer screening test done within 3 months after the visit. Finally, they compared the numbers of tests ordered and completed in the two groups.
What did the researchers find?
Colon cancer screening tests were ordered in 47% and completed in 37% of the patients who watched the videotape on colon cancer screening. These tests were ordered in 26% and completed in 23% of patients who watched the car safety video. Statistical analysis showed that rates of test ordering and completion were meaningfully higher among patients who watched the colon cancer screening video.
What were the limitations of the study?
This study involved only three doctors' practices, so the results may not be the same in practices organized differently or in those with different types of patients. You cannot tell from this study whether the video, the pamphlet, or the chart marker had the most influence on screening.
What are the implications of the study?
A decision aid that uses a video, a pamphlet, and a chart marker can increase the use of colon cancer screening in patients after visits with primary care doctors.
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