Assignment: The Study Protocol
Assignment: The Study Protocol
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Assignment: The Study Protocol
The most striking difference,
however, was that relatively few of the respon-
dents in the study by Graham et al. felt that use
of the tool saved time, which could be a reflec-
tion of either the complexity of the decisions
under consideration and ⁄or the lack of explicit instructions regarding how the tools were to be
used with respect to the timing of the interven-
tion and ⁄or need for provider involvement. Our findings also corroborate a more exten-
sive body of literature on barriers to the imple-
mentation of decision aids into clinical
practice.14 Even though our study design cir-
cumvented many of the barriers related to
workflow, accessibility and costs, only 48% of
Colorectal cancer screening decision aid, P C Schroy, S Mylvaganam and P Davidson
� 2011 John Wiley & Sons Ltd Health Expectations, 17, pp.27–35
32
providers felt that actual implementation of the
decision aids into their practices outside of the
context of a clinical trial would be easy. Ba
sed
on their feedback, however, most preferred that
the tool be used prior to initiating the screening
discussion rather than after initiation of the
discussion. Moreover, regardless of the timing, a
majority preferred that the tool be used in the
office rather than at home. Although it is quite
possible that their preferences reflected their
personal experiences with our study protocol,
Brackett et al. also found that pre-visit use was
preferred over post-visit use.18
Although responses were based on perceptions
alone and not on clinical experience, their find-
ings were similar to our own. A majority agreed
or strongly agreed that the decision aids could
meet patients� informational needs about risks and benefits and enable patients to make
informed decisions. Similarly, although many
felt that the decision aids were likely to com-
plement their usual approach, responses were
more neutral when asked about the overall
impact of the tools on the quality of the patient
encounter, patient satisfaction and issues related
to implementation.
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