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PLoS One. 2020 Jan 15;15(1):e0227304. doi: 10.1371/journal.pone.0227304. eCollection 2020.

Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening: A randomised controlled trial.

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Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.



Australian clinicians are advised to 'offer evidence-based decisional support to men considering whether or not to have a PSA test'. This randomised trial compared the performance and acceptability of two new decision aids (DAs) to aid men in making informed choices about PSA screening.


~3000 Australian men 45-60 years with varying educational attainment were recruited via an online panel and randomised to view one of two online decision aids (one full length, one abbreviated) and completed a questionnaire. The primary outcome was informed choice about PSA screening.


Significantly more men in the long DA group (38%) made an informed choice than men who received the shorter DA (33%) (95% CI 1.1% to 8.2%; p = 0.008). On knowledge, the long DA group scored, on average, 0.45 points higher than the short DA group (95% CI 0.14 to 0.76; p = 0.004) and 5% more of the participants achieved an adequate knowledge score (95% CI 1.9% to 8.8%; p = 0.002). Men allocated the long DA were less likely to intend to have a PSA test in the future (53%) than men in the short DA group (59%). Both DAs rated highly on acceptability.


Both DAs were useful and acceptable to men regardless of education level and both supported informed decision making. The long version resulted in higher knowledge, and a higher proportion of men able to make an informed choice, but the differences were small. Long DAs may be useful for men whose informational needs are not satisfied by a short DA.

Conflict of interest statement

Conflicts of interest statement: KM is supported by a NHMRC Principle Research Fellowship 1121110. JH is supported by NHMRC Early Career Fellowship #1112509. All authors declare no financial connections, direct or indirect, or other situations that might raise the question of bias in the work reported or the conclusions, implications, or opinions stated—including pertinent commercial or other sources of funding for the individual author(s) or for the associated department(s) or organization(s), personal relationships, or direct academic competition. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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