Talking, not training, increased the accuracy of physicians' diagnosis of their patients' preferences for colon cancer screening.

Identify if primary care physicians (PCPs) accurately understand patient preferences for colorectal cancer (CRC) testing, whether shared decision making (SDM) training improves understanding of patient preferences, and whether time spent discussing CRC testing improves understanding of patient preferences. Secondary analysis of a trial comparing SDM training plus a reminder arm to a reminder alone arm. PCPs and their patients completed surveys after visits assessing whether they discussed CRC testing, patient testing preference, and time spent discussing CRC testing. We compared patient and PCP responses, calculating concordance between patient-physician dyads. Multilevel models tested for differences in preference concordance by arm or time discussing CRC. 382 PCP and patient survey dyads were identified. Most dyads agreed on whether CRC testing was discussed (82%). Only 52% of dyads agreed on the patient's preference. SDM training did not impact accuracy of PCPs preference diagnoses (55%v.48%,p = 0.22). PCPs were more likely to accurately diagnose patient's preferences when discussions occurred, regardless of length. Only half of PCPs accurately identified patient testing preferences. Training did not impact accuracy. Visits where CRC testing was discussed resulted in PCPs better understanding patient preferences. PCPs should take time to discuss testing and elicit patient preferences.

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Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The study was funded through a Patient-Centered Outcomes Research Institute® (PCORI) Award (CDR-2017C3–9270). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. With regards to potential conflicts of interest for this study, all authors report grant support from PCORI (CDR-2017C3–9270) for the study activities. Dr. Sepucha reports grant funding from Agency for Healthcare Research and Quality and a contract with Blue Cross Blue Shield of Massachusetts. Dr. Atlas reports grant funding from the National Cancer Institute and the Risk Management Foundation of Harvard. Dr. Fairfield reports grant funding from the National Institutes of Health. Dr. Simmons reports paid expert testimony from the US Department of Justice for testimony on cancer screening in primary care malpractice cases.