Universität zu Köln

Krassuski, Lisa ORCID: 0000-0002-4135-3326, Vennedey, Vera ORCID: 0000-0003-4977-750X, Stock, Stephanie ORCID: 0000-0002-1726-9300 and Kautz-Freimuth, Sibylle (2019). Effectiveness of decision aids for female BRCA1 and BRCA2 mutation carriers: a systematic review. BMC Med. Inform. Decis. Mak., 19. LONDON: BMC. ISSN 1472-6947

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Abstract

Background: Female BRCA1 and BRCA2 mutation carriers have an increased lifetime risk of developing breast and/or ovarian cancer. Hence, they face the difficult decision of choosing a preventive strategy such as risk-reducing surgeries or intensified breast screening. To help these women during their decision process, several patient decision aids (DA) were developed and evaluated in the last 15years. Until now, there is no conclusive evidence on the effectiveness of these DA. This study aims 1) to provide the first systematic literature review about DA addressing preventive strategy decisions for female BRCA1 and BRCA2 mutation carriers, 2) to analyze the quality of the existing evidence, 3) to evaluate the effects of DA on decision and information related outcomes, on the actual choice for preventive measure and on health outcomes. Methods: A systematic literature review was conducted using six electronic databases (inclusion criteria: DA addressing preventive strategies, female BRCA1 and BRCA2 mutation carriers, 18 to 75years, knowledge of test result). The quality of the included randomized controlled trials (RCT) was evaluated with the Cochrane Collaboration's risk of bias tool. The quality of included one-group pretest-posttest design studies was evaluated with the ROBINS-I tool. Outcomes of included studies were extracted and qualitatively summarized. Results: A total of 2093 records were identified. Six studies were included for further evaluation (5 RCT, 1 one-group pretest-posttest design study). One RCT was formally included, but data presentation did not allow for further analyses. The risk of bias was high in three RCT and unclear in one RCT. The risk of bias in the one-group pretest-posttest study was serious. The outcome assessment showed that the main advantages of DA are linked to the actual decision process: Female BRCA1 and BRCA2 mutation carriers using a DA had less decisional conflict, were more likely to reach a decision and were more satisfied with their decision. Conclusions: Decision aids can support female BRCA1 and BRCA2 mutation carriers during their decision process by significantly improving decision related outcomes. More high-quality evidence is needed to evaluate possible effects on information related outcomes, health outcomes and the actual choice for preventive measures.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Krassuski, Lisa UNSPECIFIED orcid.org/0000-0002-4135-3326 UNSPECIFIED Vennedey, Vera UNSPECIFIED orcid.org/0000-0003-4977-750X UNSPECIFIED Stock, Stephanie UNSPECIFIED orcid.org/0000-0002-1726-9300 UNSPECIFIED Kautz-Freimuth, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145924
DOI:	10.1186/s12911-019-0872-2
Journal or Publication Title:	BMC Med. Inform. Decis. Mak.
Volume:	19
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-6947
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language CONTRALATERAL BREAST-CANCER; RANDOMIZED-TRIAL; RISK-ASSESSMENT; WOMEN; PREVALENCE; OVARIAN Multiple languages Medical Informatics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14592