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Table 6 The decision-making process about mammography screening including influencing factors

From: Scrutinizing screening: a critical interpretive review of primary care provider perspectives on mammography decision-making with average-risk women

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Tudiver 2002 NAa
Haggerty 2005 • Approximately 30% of physicians said they would order the test if it would take less time than convincing patients that they do not need it.
Meissner 2011 NAa
Smith 2012 • 94% of physicians found patients often or always thought that breast cancer was a serious threat, were aware of screening and wanted to discuss screening mammography.
• Overall approximately 75% of physicians said that lack of time was never or rarely an issue in discussing breast cancer screening with patients aged 40–49.
• 55% of physicians said they discussed the risks and benefits of screening with their patients, and allowed them to decide when screening mammography should be initiated.
Miller 2014 NAa
Kiyang 2015 • 63% of MDs showed strong or very strong intentions to support women in making informed breast cancer screening decisions.
• Perceived behavioral control was most strongly associated with intention to support, followed by attitude, and then social normal.
• Physicians most frequently reported time constraints as a barrier to supporting women, followed by women’s awareness of relevant information.
• The most frequently reported facilitator of supporting women was the availability of decision support tools for physicians and their patients.
• The next most reported facilitators were specific characteristics of targeted women and the physicians’ own knowledge about informed decision-making.
DuBenske 2017 • Physicians reported struggling to discuss screening mammography.
• Four elements had a critical impact on communication between family physicians with patients on the shared decision-making process: (a) Time constraints; (b) Risk (lack of adequate knowledge of risks and ability to communicate risk in an effective format); (c) Guidelines (confusion related to conflicting and changing guidelines); and (d) personal preferences (addressing patient preferences that contradict guidelines and addressing physician’s own biases).
• Physicians reported a concern for time constraints, and noted they act as a barrier on being able to thoroughly consider all risk factors and offer individual recommendations. They also desired efficiency in the screening discussion.
• Physicians report that they do have brief conversations about potential outcomes of screening, yet women in this study reported receiving limited or no information about them.
• Both identify and support patient preference for varying degrees of involvement in decision-making. Both desire women to understand their risks. Both see the value in preparing women for potential call-backs and next steps, however, women report this does not happen whereas many physicians reported that they do discuss this.
• Many women trust their physicians understand guidelines and use them in directing their decision; physicians identify ambiguity in the available guidelines.
Radhakrishnan 2017 NAa
Radhakrishnan 2018 NAa
  1. aNA, not applicable