UPmémoires

English

Introduction: Shared decision-making is a decision-making model where, following an exchange of information and deliberation between patient and health professional, both parties converge toward an accepted decision. This approach values a patient-centered approach. In France and in United Kingdom, decision-making aids for cervical cancer screening are available through leaflets and websites. We collected and analyzed all of these data from the National Health Service and French Health Insurance for evaluation using the up to date scientific evidence criteria from IPDAS. Evaluation according to IPDAS criteria: Several points were missing in all analyzed aids: the level of evidence of related scientific studies, the disease prevalence in absolute value, the effectiveness of cervical cancer screening and its expected benefit of morbidity/mortality decreasing in absolute value. Cancer-related complications are mentioned only by British aid. Finally, risks of complications related to screening are incompletely mentioned by aids of the two countries. Discussion: The absence of data expressed in absolute value and explanation about low scientific evidence provides truncated information that promotes participation and influences choice for screening. The limits of cervical smear screening should be mentioned to inform patients about risks of over-diagnosis, over-treatment, and specific complications. Lack of participation should be recognized as a choice in its own right and systematically mentioned. Perspective of improvement: We propose that to systematically deliver to the patient a verified information easy to understand and to write the aids in partnership with patient associations. Conclusion: As of today, the proposed aids are not suitable for the decision-making of patients about their participation in screening. The health professional's role is central to discuss with the patient the quality of the delivered information and to support decision-making process.

Keywords : shared decision making, decison-aids, screening, cervical cancer.