Dr. Erin Mathieu is an Epidemiologist and works as the Lecturer in Community Research. She works closely with the Year 4 Medical students on their Community Research rotation, and provides advice regarding study design, data collection, data analysis and report writing to the students. Her research interests include research methodology, informed choice, adolescent health and physical activity. Erin has a PhD, MPH (Hons) and B.Ed, all from the University of Sydney.
Questions & Answers
The research and numbers behind the decision aid are aimed at women aged 40 who are thinking about having a mammography for breast cancer screening. However the decision aid could be adapted to older age groups, with different numbers to reflect the changing risk of outcomes. We are currently trialling a decision aid for women aged 50-69 years to help them make a decision about breast cancer screening with mammography. The decision aid could even be adapted to different cancer screening tests, such as the PSA test, with different options, outcomes and uncertainties presented that are specific to the disease.
The great thing about an online decision aid is that it is practical and easy to use. It is available online, so if you have internet access you can use the decision aid at home, your local library, or even when you’re out, such as at a doctor’s appointment, via a mobile phone or tablet. This is more convenient and discreet than having to obtain hard copies through a specific organisation. The biggest challenge to implementation would be making women aware of the decision aid before making a decision. Providers opposed to shared decision making, or other people imposing their own values and preferences on women making a decision about breast cancer screening could also pose a challenge.
One of the main objectives of a decision aid is to enhance informed, values-based decision-making by patients. So when evaluating the decision aid, practitioners should ask the question “has my patient made an informed choice with regards to breast cancer screening?” An informed choice is one that is consistent with their knowledge, attitude and beliefs.
We want to improve the health and wellbeing of women by helping them understand that there are choices when it comes to breast cancer screening. So our current research is focused on measuring the benefits and harms of breast cancer screening and clearly communicate this information to the community. We are also assessing a decision aid about important outcomes of mammography screening over 20 years for women aged 50 compared with no screening. The information is presented in a short booklet, using a combination of text and visual formats, similar to the online presentation.