Shared decision making in breast cancer screening guidelines: a systematic review of their quality and reporting

Abstract Background Shared decision making (SDM) is a key component of evidence-based and patient-centred care. The aim of this study is to systematically review the quality of SDM proposals in clinical practice guidelines (CPGs) and consensus statements (CSs) concerning breast cancer (BC) screening...

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Published in:European journal of public health 2021-08, Vol.31 (4), p.873-883
Main Authors: Maes-Carballo, Marta, Moreno-Asencio, Teresa, Martín-Díaz, Manuel, Mignini, Luciano, Bueno-Cavanillas, Aurora, Khan, Khalid Saeed
Format: Article
Language:English
Subjects:
Breast cancer
Cancer
Cancer screening
Clinical decision making
Data quality
Decision making
Diagnosis
Evidence-based medicine
Guidelines
Medical screening
Practice guidelines (Medicine)
Professional associations
Public health
Quality assessment
Quality control
Systematic review
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Summary:Abstract Background Shared decision making (SDM) is a key component of evidence-based and patient-centred care. The aim of this study is to systematically review the quality of SDM proposals in clinical practice guidelines (CPGs) and consensus statements (CSs) concerning breast cancer (BC) screening. Methods Guidances were identified, without language restrictions, using a prospectively planned systematic search (MEDLINE, EMBASE, Web of Science, Scopus and guideline websites) from January 2010 to August 2020. Duplicate data extraction used a 31-item SDM quality assessment tool; reviewer agreement was 98%. Results SDM appeared only in 38 (49.4%) (33/68 CPGs, 4/9 CSs) documents (overall compliance with the quality tool: mean 5.74, IQR 3–8). CPGs and CSs specifically mentioning the term SDM (n = 12) had higher quality (mean 6.8, IQR 4–9 vs. mean 2.1, IQR 0–3; P = 0.001). No differences were found in mean quality comparing CPGs with CSs (3 vs. 1.6; P = 0.634), use of systematic review (4.2 vs. 2.9; P = 0.929) and publication in a journal (4 vs. 1.9; P = 0.094). Guidances with SDM were more recently reported than those without it (mean 41 vs. 57 months; P = 0.042). Conclusion More than half of all the guidelines did not meet SDM quality criteria. Those that explored it were more recently reported. There is an urgent need for promoting SDM in guidances concerning BC screening issued by institutions, professional associations and medical journals.
ISSN:1101-1262
1464-360X
1464-360X
DOI:10.1093/eurpub/ckab084