We conducted a focus group to assess the attitudes of primary care physicians (PCPs) toward prostate-specific antigen (PSA)-screening algorithms, perceptions of using decision support tools, and features that would make such tools feasible to implement.
A multidisciplinary team (primary care, urology, behavioral sciences, bioinformatics) developed the decision support tool that was presented to a focus group of 10 PCPs who also filled out a survey. Notes and audio-recorded transcripts were analyzed using Thematic Content Analysis.
The survey showed that PCPs followed different guidelines. In total, 7/10 PCPs agreed that engaging in shared decision-making about PSA screening was burdensome. The majority (9/10) had never used a decision aid for PSA screening. Although 70% of PCPs felt confident about their ability to discuss PSA screening, 90% still felt a need for a provider-facing platform to assist in these discussions. Three major themes emerged: (1) confirmatory reactions regarding the importance, innovation, and unmet need for a decision support tool embedded in the electronic health record; (2) issues around implementation and application of the tool in clinic workflow and PCPs' own clinical bias; and (3) attitudes/reflections regarding discrepant recommendations from various guideline groups that cause confusion.
There was overwhelmingly positive support for the need for a provider-facing decision support tool to assist with PSA-screening decisions in the primary care setting. PCPs appreciated that the tool would allow flexibility for clinical judgment and documentation of shared decision-making. Incorporation of suggestions from this focus group into a second version of the tool will be used in subsequent pilot testing.
Applied clinical informatics. 2024 Apr 10 [Epub]
Sigrid V Carlsson, Mark Preston, Andrew Vickers, Deepak Malhotra, Behfar Ehdaie, Michael Healey, Adam S Kibel
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States., Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States., Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States., Organizations, and Markets Unit, Harvard Business School, Boston, Massachusetts, United States., Brigham and Women's Hospital Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, United States.