Evidence map›Paper›PMID 32128689›Full record

ArticleJournal of general internal medicine2020

Scripts and Strategies for Discussing Stopping Cancer Screening with Adults > 75 Years: a Qualitative Study.

Mara A Schonberg, Alicia R Jacobson, Maria Karamourtopoulos, Gianna M Aliberti, Adlin Pinheiro, Alexander K Smith, Linnaea C Schuttner, Elyse R Park, Mary Beth Hamel

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06896474 (SDM POSSIBLE), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06896474 narecruitingnot on this mapstarted 2026, after this paper: background citation

SDM POSSIBLE: A Cluster RCT of a Breast Cancer Treatment Decision Aid for Women 70+ With Low-Risk Stage I Breast Cancers

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2026 to 2033Enrolled402ConditionsBreast CancerArmsShared Decision-Making Training and Decision Aid
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Mara A SchonbergDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA. mschonbe@bidmc.harvard.edu.ORCID 0000-0001-5162-5922
Alicia R JacobsonDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA.
Maria KaramourtopoulosDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA.
Gianna M AlibertiDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA.
Adlin PinheiroDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, USA.
Linnaea C SchuttnerHealth Services Research & Development, VA Puget Sound Health Care System, Department of Medicine, University of Washington, Seattle, WA. 1959 NE Pacific St, Seattle, WA, 98195, USA.
Elyse R ParkDepartment of Psychiatry, Massachusetts General Hospital, 450 Brookline Avenue, Boston, MA, 02215, USA.
Mary Beth HamelDivision of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon, Office 219, Brookline, MA, 02446, USA.
Beth Israel Deaconess Medical Center · USMassachusetts General Hospital · USUniversity of California, San Francisco · USUniversity of Washington · US

Funding

Discussions of Prognosis and Stopping Cancer Screening in Older AdultsR21CA212386 · NCI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHONBERG, MARA A · 2017 to 2018
$425k
NCI NIH HHS R21 CA212386NIH HHS R21CA212386
6 · The paper itself

Abstract

backgroundDespite guidelines recommending not to continue cancer screening for adults > 75 years old, especially those with short life expectancy, primary care providers (PCPs) feel ill-prepared to discuss stopping screening with older adults.

objectiveTo develop scripts and strategies for PCPs to use to discuss stopping cancer screening with adults > 75.

designQualitative study using semi-structured interview guides to conduct individual interviews with adults > 75 years old and focus groups and/or individual interviews with PCPs.

participantsForty-five PCPs and 30 patients > 75 years old participated from six community or academic Boston-area primary care practices. APPROACH: Participants were asked their thoughts on discussions around stopping cancer screening and to provide feedback on scripts that were iteratively revised for PCPs to use when discussing stopping mammography and colorectal cancer (CRC) screening.

resultsTwenty-one (47%) of the 45 PCPs were community based. Nineteen (63%) of the 30 patients were female, and 13 (43%) were non-Hispanic white. PCPs reported using different approaches to discuss stopping cancer screening depending on the clinical scenario. PCPs noted it was easier to discuss stopping screening when the harms of screening clearly outweighed the benefits for a patient. In these cases, PCPs felt more comfortable being more directive. When the balance between the benefits and harms of screening was less clear, PCPs endorsed shared decision-making but found this approach more challenging because it was difficult to explain why to stop screening. While patients were generally enthusiastic about screening, they also reported not wanting to undergo tests of little value and said they would stop screening if their PCP recommended it. By the end of participant interviews, no further edits were recommended to the scripts.

conclusionsTo increase PCP comfort and capability to discuss stopping cancer screening with older adults, we developed scripts and strategies that PCPs may use for discussing stopping cancer screening.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerAgedFemaleHumansMaleMammographyMass ScreeningQualitative Researchcancer screeningdeprescribingolder adults

Identifiers

PMID32128689
PMCPMC7351918
OpenAlexW3009943310

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.