Table 2.
Items That Achieved Consensus in Round 1 and Were Deemed Core Elements of SDM for Breast Cancer Screening. Each Cell Shows Percentage and Number (in Parentheses) of Panelists That Selected Either Very or Extremely Important
| Item | Women 40–49 | PCPs | HDSs | Total |
|---|---|---|---|---|
| a. Items that achieved consensus aligned with the theme information delivery and patient education (ID) | ||||
| PCPs should tell women that their risk of breast cancer is based on their personal risk factors. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should identify and explain a woman’s personal breast cancer risk factors. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should correct any misunderstandings a woman may have about information they provide about mammography for breast cancer screening. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should tell a woman the benefits of having mammography screening. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should tell a woman the risks of having mammography screening. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should tell women that screening could reduce the risk of negative outcomes (cancer getting worse, death) if they develop breast cancer by giving them options to seek treatment. | 100% (10/10) | 90% (9/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs should tell women that not screening could increase the risk of negative outcomes (cancer getting worse, death) if they develop breast cancer. | 90% (9/10) | 100% (10/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs should explain that information relating to risk has uncertainties and is not a guarantee. | 70% (7/10) | 100% (10/10) | 100% (7/7) | 88.9% (24/27) |
| PCPs should tell a woman the benefits of not having mammography screening. | 80% (8/10) | 90% (9/10) | 100% (7/7) | 88.9% (24/27) |
| Healthcare systems should use language and word choice when presenting information about mammography and breast cancer risk that research has shown to be the most effective for aiding women’s understanding. | 90% (9/10) | 80% (8/10) | 100% (7/7) | 88.9% (24/27) |
| PCPs should present both sides of the decision to have mammography or not and not try to persuade. | 80% (8/10) | 100% (10/10) | 86% (6/7) | 88.9% (24/27) |
| PCPs should tell a woman the risks of not having mammography screening. | 80% (8/10) | 100% (10/10) | 86% (6/7) | 88.9% (24/27) |
| PCPs and women should discuss the alternatives to mammography screening. | 90% (9/10) | 90% (9/10) | 86% (6/7) | 88.9% (24/27) |
| PCPs should tell a woman the risks of overtreatment. | 70% (7/10) | 100% (10/10) | 86% (6/7) | 85.2% (23/27) |
| Healthcare systems should present statistics regarding mammography and breast cancer risk in a manner that research has shown to be the most effective for aiding women’s understanding. | 90% (9/10) | 60% (6/10) | 100% (7/7) | 81.5% (22/27) |
| b. Items that achieved consensus aligned with the theme interpersonal clinician-patient communication (COM) | ||||
| PCPs should present information regarding mammography and breast cancer in the most clear and understandable way. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should check with a woman to make sure she understands the information. | 90% (9/10) | 100% (10/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs should express genuine care and concern for the woman. | 90% (9/10) | 100% (10/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs should present both sides of the decision to have mammography or not and not try to persuade. | 80% (8/10) | 100% (10/10) | 86% (6/7) | 88.9% (24/27) |
| c. Items that achieved consensus aligned with the theme of framework of the decision (FD) | ||||
| PCPs should act with sensitivity to cultural beliefs and behaviors. | 100% (10/10) | 100% (10/10) | 100% (7/7) | 100% (27/27) |
| PCPs should tell women there is a decision to make about breast cancer screening. | 90% (9/10) | 100% (10/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs and women should discuss a woman’s role in decision-making. | 90% (9/10) | 100% (10/10) | 100% (7/7) | 96.3% (26/27) |
| PCPs and women should discuss a woman’s values with regard to a screening mammogram. | 70% (7/10) | 100% (10/10) | 100% (7/7) | 88.9% (24/27) |
| PCPs and women should discuss a woman’s preferences with regard to a screening mammogram. | 70% (7/10) | 100% (10/10) | 100% (7/7) | 88.9% (24/27) |
| PCPs should accept that a woman’s informed decision on her own care may not necessarily be one that reduces risk. | 70% (7/10) | 100% (10/10) | 100% (7/7) | 88.9% (24/27) |
| PCPs and women should discuss the nature of the decision to be made (whether and how often to use mammography for breast cancer screening). | 80% (8/10) | 80% (8/10) | 100% (7/7) | 85.2% (23/27) |
| PCPs and women should discuss a woman’s personal values and preferences in general. | 70% (7/10) | 100% (10/10) | 86% (6/7) | 85.2% (23/27) |