Assignment: The Study Protocol

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Assignment: The Study Protocol

Assignment: The Study Protocol

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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


providers felt that actual implementation of the

decision aids into their practices outside of the

context of a clinical trial would be easy. Ba



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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