Evidence map›Paper›PMID 41945984›Full record

Trial reportPatient education and counseling2026

Exploring older adults' tolerance of uncertainty in colorectal cancer screening decisions.

Hoda Fakhari, K D Valentine, Karen Sepucha, Steven J Atlas, Lauren Leavitt, Leigh H Simmons, Lydia C Siegel, James M Richter, Kathleen M Fairfield, Paul K J Han

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Patient education and counseling, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Hoda FakhariDepartment of Communication Studies, School of Communication, Northwestern University, Evanston, IL, USA. Electronic address: hoda@u.northwestern.edu.
K D ValentineDivision of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Karen SepuchaDivision of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Steven J AtlasDivision of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Lauren LeavittDivision of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Leigh H SimmonsDivision of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Lydia C SiegelHarvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
James M RichterHarvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
Kathleen M FairfieldDepartment of Medicine, MaineHealth, Portland, ME, USA.
Paul K J HanDivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

Funding

Intramural NIH HHS Z99 CA999999Patient-Centered Outcomes Research Institute CDR-2017C3-9270
6 · The paper itself

Abstract

objectivesUncertainty tolerance is an important characteristic thought to influence medical judgments and decisions. However, patients' tolerance of different types of uncertainty may vary and have different effects. The current study explored how tolerance of different types of uncertainty relates to decision-related outcomes among older adults considering colorectal cancer (CRC) screening.

methodsA secondary analysis of data from a cluster randomized clinical trial of an intervention to improve shared decision making (SDM) for older adults considering CRC screening was conducted. Patients completed a questionnaire following clinic visits, including measures of tolerance of uncertainty due to ambiguity (Ambiguity Aversion in Medicine) and complexity (Geller Tolerance of Ambiguity), as well as key decision-related cognitive, affective, and behavioral variables: perceived benefit of screening, concern about harms of screening, and CRC screening intention. Multilevel regression analyses were used to evaluate the associations between tolerance of uncertainty and decision-related variables as well as various patient characteristics.

resultsThe sample (N = 448) ranged in age from 76 to 85 (M=80, SD=3), and 53.7% were female, 94% were white, and 72% had at least a 4-year college degree. Higher tolerance of ambiguity, but not complexity, was associated with higher perceived benefit of screening (b=-0.077, p < 0.001). Higher tolerance of ambiguity (b=0.08, p < 0.01) and complexity (b=0.06, p < 0.05) were associated with lower concern about harms of screening, although neither were associated with CRC screening intentions.

conclusionsTolerance of uncertainty due to ambiguity and complexity have different associations with key cognitive and affective variables related to older adults' CRC screening decisions, but not screening intentions. Patients' tolerance of different types of uncertainty may influence their responses to medical decisions involving uncertainty. PRACTICE IMPLICATIONS: By assessing different types of uncertainty tolerance, clinicians may be able to better tailor their approach to patient communication and SDM to improve decision quality.

Indexed as

Colorectal NeoplasmsDecision MakingDecision Making, SharedEarly Detection of CancerMass ScreeningPatient ParticipationAgedAged, 80 and overFemaleHumansMaleSurveys and QuestionnairesUncertaintyColorectal cancer screeningShared decision makingUncertaintyUncertainty tolerance

Identifiers

PMID41945984
PMCPMC13162534

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Registered trials

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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.