Use of decision aids to support informed choices about screening

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Abstract
Introduction Patients should be able to participate in health decisions, if they so choose. Decision aids have been developed to help patients make informed decisions about treatment and have been found to improve knowledge, reduce indecision, and improve agreement between values and choice.1 However, in screening, where informed choice is not common practice,2 decision aids are controversial and their effect is currently unknown.3 4 Nevertheless, the complexities of decisions about screening mean that decision aids could be of immense value. In this paper we highlight eight issues that are critically important for the development and use of high quality decision aids about screening. Some of these issues arise because of fundamental differences between screening and treatment interventions; other issues flow from widespread uncritical support for screening, as illustrated by the storm over PSA (prostate specific antigen) screening for prostate cancer.5 6