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Decision aids for breast cancer screening in women approximately 50 years of age: A systematic review and meta-analysis of randomised controlled trials.

AIMS AND OBJECTIVES
Review the content, quality and effect of breast cancer screening decision aids (BCS-DAs) in women approximately 50 years of age to provide a basis for the development of DAs.


BACKGROUND
Breast cancer screening (BCS) decisions are complex and should vary depending on a woman's risk of breast cancer and her values and preferences. Decision aids (DAs) can help support women and medical staff in shared decision-making (SDM) when solving BCS problems.


DESIGN
Systematic review and meta-analysis.


METHODS
Four databases were searched starting at the time of establishment of the database to March 2021. The PRISMA checklist was followed. The meta-analysis was carried out using Review Manager 5.3 software. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. The quality of the DAs was assessed using the International Standards for Decision Aid (IPDASi v4.0).


RESULTS
The search strategy obtained 2024 references. After abstraction and full text screening, a total of seven studies were included. This article systematically reviews the content, quality and effectiveness of DAs in seven RCTs in helping women to make BCS decisions. The DAs were mostly in paper or online form and displayed disease screening information, analysed the benefits and harms of options and clarified the value to patients. Among all the DAs, only one met the minimum quality standards of IPDASi v4.0. Comprehensive analysis shows that DAs can significantly improve knowledge and increase the proportion of women who make informed choices, but they have no effect on screening attitude, intention, decision conflict or regret.


CONCLUSIONS
In the future, nurses should be encouraged to develop DAs in accordance with strict standards and to make them applicable to young women of different backgrounds.


RELEVANCE TO CLINICAL PRACTICE
The result may be provide a basis for the development of DAs to promote women's informed screening choices.