Scolaris Content Display Scolaris Content Display

Comunicación personalizada de riesgos para la toma de decisiones informada sobre la participación en pruebas de detección

Collapse all Expand all

References

References to studies included in this review

Jump to:

Bastani 1999 {published data only}

Bastani R, Maxwell AE, Bradford C, Das IP, Yan KX. Tailored risk notification for women with a family history of breast cancer. Preventive Medicine 1999;29(5):355‐64.

Bloom 2006 {published data only}

Bloom JR, Stewart SL, Chang S, You M. Effects of a telephone counseling intervention on sisters of young women with breast cancer. Preventive Medicine 2006;43(5):379‐84.

Bodurtha 2009 {published data only}

Bodurtha J, Quillin JM, Tracy KA, Borzelleca J, McClish D, Wilson DB, et al. Mammography screening after risk‐tailored messages: the Women Improving Screening through Education and Risk assessment (WISER) randomized controlled trial. Journal of Women's Health 2009;18(1):41‐7.

Bowen 2002 {published data only}

Bowen D, Burke W, Yasui Y, McTiernan A, McLeran D. Effects of risk counseling on interest in breast cancer genetic testing for lower risk women. Genetics in Medicine 2002;4(5):359‐65.

Bowen 2006 {published data only}

Bowen DJ, Powers D, Greenlee H. Effects of breast cancer risk counseling for sexual minority women. Health Care for Women International 2006;27(1):59‐74.

Bowen 2010 {published data only}

Bowen DJ, Powers D. Effects of a mail and telephone intervention on breast health behaviors. Health Education and Behavior 2010;37(4):479‐89.

Campbell 1997 {published data only}

Campbell E, Peterkin D, Abbott R, Rogers J. Encouraging underscreened women to have cervical cancer screening: the effectiveness of a computer strategy. Preventive Medicine 1997;26(6):801‐7.

Champion 1994 {published data only}

Champion V. Strategies to increase mammography utilization. Medical Care 1994;32(2):118‐29.

Champion 1995 {published data only}

Champion V, Huster G. Effect of interventions on stage of mammography adoption. Journal of Behavioral Medicine 1995;18(2):169‐87.

Champion 2000a {published data only}

Champion VL, Ray DW, Heilman DK, Springston J. A tailored intervention for mammography among low‐income African‐American women. Journal of Psychosocial Oncology 2000;18(4):1‐13.

Champion 2002 {published data only (unpublished sought but not used)}

Champion V, Skinner C, Menon U, Seshadri R, Anzalone D, Rawl S. Comparisons of tailored mammography interventions at two months postintervention. Annals of Behavioral Medicine 2002;24(3):211‐8.

Champion 2003 {published data only}

Champion V, Maraj M, Hui S, Perkins AJ, Tierney W, Menon U, et al. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Preventive Medicine 2003;36(2):150‐8.

Champion 2007 {published data only}

Champion V, Skinner CS, Hui S, Monahan P, Juliar B, Daggy J, Menon U. The effect of telephone versus print tailoring for mammography adherence. Patient Education and Counseling 2007;65(3):416‐23.

Curry 1993 {published data only}

Curry SJ, Taplin SH, Anderman C, Barlow WE, McBride C. A randomized trial of the impact of risk assessment and feedback on participation in mammography screening. Preventive Medicine 1993;22(3):350‐60.

Geller 2006 {published data only}

Geller AC, Emmons KM, Brooks DR, Powers C, Zhang Z, Koh HK, et al. A randomized trial to improve early detection and prevention practices among siblings of melanoma patients. Cancer 2006;107(4):806‐14.

Glanz 2007 {published data only}

Glanz K, Steffen AD, Taglialatela LA. Effects of colon cancer risk counseling for first‐degree relatives. Cancer Epidemiology, Biomarkers & Prevention 2007;16(7):1485‐91.

Glazebrook 2006 {published data only}

Glazebrook C, Garrud P, Avery A, Coupland C, Williams H. Impact of multimedia intervention "Skinsafe" on patients' knowledge and protective behaviours. Preventive Medicine 2006;42:449‐54.

Helmes 2006 {published data only}

Helmes AW, Culver JO, Bowen DJ. Results of a randomized study of telephone versus in‐person breast cancer risk counseling. Patient Education and Counseling 2006;64(1‐3):96‐103.

Hutchison 1998 {published data only}

Hutchison B, Birch S, Evans C, Goldsmith L, Markham B, Frank J, Paterson M. Screening for hypercholesterolaemia in primary care: randomised controlled trial of postal questionnaire appraising risk of coronary heart disease. BMJ 1998;316(7139):1208‐13.

Jibaja‐Weiss 2003 {published data only}

Jibaja‐Weiss M, Volk R, Kingery P, Smith Q, Holcomb J. Tailored messages for breast and cervical cancer screening of low‐income and minority women using medical records data. Patient Education and Counseling 2003;50(2):123‐32.
Jibaja‐Weiss M, Volk R, Smith Q, Holcomb J, Kingery P. Differential effects of messages for breast and cervical cancer screening. Journal of Health Care for the Poor and Underserved 2005;16(1):42‐52.

Kreuter 1996 {published data only}

Kreuter MW, Strecher VJ. Do tailored behaviour change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial. Health Education Research 1996;11(1):97‐105.

Lee 1991 {published data only}

Lee CY. A randomized controlled trial to motivate work site fecal occult blood testing. Yonsei Medical Journal 1991;32(2):131‐8.

Lerman 1995 {published data only}

Lerman C, Lustbader E, Rimer B, Daly M, Miller S, Sands C, et al. Effects of individualized breast cancer risk counseling: a randomised trial. Journal of the National Cancer Institute 1995;87(4):286‐92.
Lerman C, Schwartz MD, Miller SM, Daly M, Sands C, Rimer BK. A randomized trial of breast cancer risk counseling: interacting effects of counseling, educational level, and coping style. Health Psychology 1996;15(2):75‐83.

Lerman 1997 {published data only}

Lerman C, Biesecker B, Bekendorf JL, Kerner J, Gomez‐Caminero A, Hughes C, et al. Controlled trial of pretest education approaches to enhance informed decision‐making for BRCA1 gene testing. Journal of the National Cancer Institute 1997;89(2):148‐57.

Lipkus 2005 {published data only}

Lipkus I, Skinner C, Dement J, Pompeii L, Moser B, Samsa G, et al. Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions. Preventive Medicine 2005;40(5):489‐501.
Lipkus I, Skinner C, Green L, Dement J, Samsa G, Ransohoff D. Modifying attributions of colorectal cancer risk. Cancer Epidemiology Biomarkers and Prevention 2004;13(4):560–6.

Lipkus 2007b {published data only}

Lipkus IM, Klien WM. Effects of communicating social comparison information on risk perceptions for colorectal cancer. Journal of Health Communication 2007;11(4):391‐407.

Manne 2009 {published data only}

Manne S, Coups EJ, Markowitz A, Meropol NJ, Haller D, Jacobsen PB, et al. A randomized trial of generic versus tailored interventions to increase colorectal cancer screening among intermediate risk siblings. Annals of Behavioral Medicine 2009;37(2):207‐17.

Manne 2010 {published data only}

Manne S, Jacobsen PB, Ming ME, Winkel G, Dessureault S, Lessin SR. Tailored versus generic interventions for skin cancer risk reduction for family members of melanoma patients. Health Psychology 2010;29(6):583‐93.

Marcus 2005 {published data only}

Marcus AC, Mason M, Wolfe P, Rimer BK, Lipkus I, Strecher V, et al. The efficacy of tailored print materials in promoting colorectal cancer screening: results from a randomized trial involving callers to the National Cancer Institute's cancer information service. Journal of Health Communication 2005;10(1):83‐104.

Myers 1999 {published data only}

Myers R, Chodak G, Wolf T, Burgh D, McGrory G, Marcus S, et al. Adherence by African American men to prostate cancer education and early detection. Cancer 1999;86(1):88‐104.

Nagle 2008 {published data only}

Nagle C, Gunn J, Bell R, Lewis S, Meiser B, Metcalfe S, et al. Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial. British Journal of Obstetrics and Gynaecology 2008;115(3):339‐47.

Rawl 2008 {published data only}

Rawl SM, Champion VL, Scott LL, Zhou H, Monahan P, Ding Y, et al. A randomized trial of two print interventions to increase colon cancer screening among first degree relatives. Patient Education and Counseling 2008;71(2):215‐27.

Rimer 2002 {published data only}

Rimer B, Halabi S, Skinner C, Lipkus I, Strigo T, Kaplan E, et al. Effects of a mammography decision‐making intervention at 12 and 24 months. American Journal of Preventive Medicine 2002;22(4):247‐57.
Rimer B, Halabi S, Sugg Skinner C, Kaplan E, Crawford Y, Samsa G, et al. The short‐term impact of tailored mammography decision‐making interventions. Patient Education and Counseling 2001;43(3):269‐85.

Saywell 1999 {published data only}

Saywell RM, Champion VL, Skinner CS, McQuillen D, Martin D, Maraj M. Cost‐effectiveness comparison of five interventions to increase mammography screening. Preventive Medicine 1999;29(5):374‐82.

Schwartz 1999 {published data only}

Schwartz M, Rimer B, Daly M, Sands C, Lerman C. A randomized trial of breast cancer risk counseling: the impact on self‐reported mammography use. American Journal of Public Health 1999;89(6):924‐6.

Sequist 2011 {published data only}

Sequist T, Zaslavsky A, Ayanian J, Colditz G. Electronic patient messages and personalized risk assessments to promote colorectal cancer screening: a randomised controlled trial. Journal of General Internal Medicine 2011;25:636‐41.

Skinner 1994 {published data only (unpublished sought but not used)}

Skinner CS, Strecher VJ, Hospers H. Physicians' recommendations for mammography: do tailored messages make a difference?. American Journal of Public Health 1994;84(1):43‐9.

Skinner 2002 {published data only}

Skinner C, Schildkraut J, Berry D, Calingaert B, Marcom P, Sugarman J, et al. Pre‐counseling education materials for BRCA testing: does tailoring make a difference?. Genetic Testing 2002;6(2):93‐105.

Smith 2010 {published data only}

Smith SK, Trevena L, Simpson JM, Barratt A, Nutbeam D, McCaffery KJ. A decision aid to support informed choices about bowel cancer screening among adults with low education: randomised controlled trial. BMJ (Clinical research ed.) 2010;341:c5370.

Steckelberg 2011 {published data only}

Steckelberg A, Hulfenhaus C, Haastert B, Muhlhauser I. Effect of evidence based risk information on "informed choice" in colorectal cancer screening: randomised controlled trial. BMJ 2011;342:d3193.

Trevena 2008 {published data only}

Trevena LJ,   Irwig L, Barratt A. Randomized trial of a self‐administered decision aid for colorectal cancer screening. Journal of Medical Screening 2008;15(2):76‐82.

References to studies excluded from this review

Jump to:

Alexander 1996 {published data only}

Alexander NE, Ross J, Sumner W, Nease RF, Littenberg B. The effect of an educational intervention on the perceived risk of breast cancer. Journal of General Internal Medicine 1996;11(2):92‐7.

Arimori 2006 {published data only}

Arimori N. Randomized controlled trial of decision aids for women considering prenatal testing: the effect of the Ottawa Personal Decision Guide on decisional conflict. Japan Journal of Nursing Science 2006;3:119‐30.

Champion 2000b {published data only}

Champion V, Skinner C, Foster J. The effects of standard care counseling or telephone/in‐person counseling on beliefs, knowledge, and behavior related to mammography screening. Oncology Nursing Forum 2000;27(10):1565‐71.

Champion 2006b {published data only}

Champion VL, Springston JK, Zollinger TW, Saywell Jr RM, Monahan PO, Zhao Q, et al. Comparison of three interventions to increase Mammography screening in low income African American women. Cancer Detection and Prevention 2006;30:535‐44.

Chan 2011 {published data only}

Chan ECY, McFall SL, Byrd TL, Mullen PD, Volk RJ, Ureda J, et al. A community‐based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT. Patient Education and Counseling 2011;84:e44‐51.

Costanza 2007 {published data only}

Costanza ME, Luckmann R, Stoddard AM, White M, Stark JR, Avrunin JS, et al. Using tailored telephone counseling to accelerate the adoption of colorectal cancer screening. Cancer Detection and Prevention 2007;31:191‐8.

Dignan 1996 {published data only}

Dignan M, Michielutte R, Blinson K, Wells HB, Case LD, Sharp P, et al. Effectiveness of health education to increase screening for cervical cancer among eastern band Cherokee Indian women in North Carolina. Journal of the National Cancer Institute 1996;88(22):1670‐6.

Engelstad 2005 {published data only}

Engelstad L, Stewart S, Otero‐Sabogal R, Leung M, Davis P, Pasick R. The effectiveness of a community outreach intervention to improve follow‐up among underserved women at highest risk for cervical cancer. Preventive Medicine 2005;41(3):741‐8.

Gagnon 1996 {published data only}

Gagnon P, Massie MJ, Gronert M, Heerdt AS, Brown K, et al. Perception of breast cancer risk and psychological distress in women attending a surveillance program. Psycho‐oncology 1996;5:259‐69.

Giles 2001 {published data only}

Giles JT, Kennedy DT, Dunn EC, Wallace WL, Meadows SL, Cafiero AC. Results of a community pharmacy‐based breast cancer risk‐assessment and education program. Pharmacotherapy 2001;21(2):243‐53.

Jerant 2007 {published data only}

Jerant A, Kravitz RL, Rooney M, Amerson S, Kreuter M, Franks P. Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: a randomized controlled pilot study in physician offices. Patient Education and Counseling 2007;66:67‐74.

Kadison 1998 {published data only}

Kadison P, Pelletier EM, Mounib EL, Oppedisano P, Harry T. Improved screening for breast cancer associated with a telephone‐based risk assessment. Preventive Medicine 1998;27(3):493‐501.

Kreuter 2005 {published data only}

Kreuter M, Sugg‐Skinner C, Holt C, Clark E, Haire‐Joshu D, Fu Q, et al. Cultural tailoring for mammography and fruit and vegetable intake among low‐income African‐American women in urban public health centers. Preventive Medicine 2005;41(1):53‐62.

Leigh 1991 {published data only}

Leigh J, Harrison J. Reduction of ischaemic heart disease risk factors following direct probabilistic risk communication in the workplace. Journal of Occupational Health & Safety 1991;7:467‐72.

Lipkus 2000 {published data only}

Lipkus IM, Rimer BK, Halabi S, Strigo TS. Can tailored interventions increase mammography use among HMO women?. American Journal of Preventive Medicine 2000;18(1):1‐10.

Miller 2005 {published data only}

Miller S, Fleisher L, Roussi P, Buzaglo J, Schnoll R, Slater E, et al. Facilitating informed decision making about breast cancer risk and genetic counseling among women calling the NCI's Cancer Information Service. Journal of Health Communication 2005;10(Suppl 1):119‐36.

Misra 2011 {published data only}

Misra S, Lairson DR, Chan W, Chang Y, Bartholomew LK, Greisinger A, et al. Cost effectiveness of interventions to promote screening for colorectal cancer: a randomized trial. Journal of Preventative Medicine and Public Health 2011;44(3):101‐10.

Myers 2007 {published data only}

Myers RE, Sifri R, Hyslop T, Rosenthal M, Vernon SW, Cocroft J, et al. A randomized control trial of the impact of targeted and tailored interventions on colorectal cancer screening. Cancer 2007;110(9):2083‐91.

Ockhuysen‐Vermey 2008 {published data only}

Ockhuysen‐Vermey CF, Henneman L, Van Asperen CJ, Oosterwijk JC, Menko FH, Timmermans DRM. Design of the BRISC study: a multicentre controlled clinical trial to optimize the communication of breast cancer risks in genetic counseling. BioMed Central Cancer 2008;8:283.

Pye 1988 {published data only}

Pye G, Christie M, Chamberlain JO, Moss SM, Hardcastle JD. A comparison of methods for increasing compliance within a general practitioner based screening project for colorectal cancer and the effect on practitioner workload. Journal of Epidemiology and Community Health 1988;42(1):66‐71.

Rakowski 1998 {published data only}

Rakowski W, Ehrich B, Goldstein MG, Rimer BK, Pearlman DN, Clark MA, et al. Increasing mammography among women aged 40‐74 by use of a stage‐matched, tailored intervention. Preventive Medicine 1998;27(5 pt 1):748‐56.

Rhodes 2001 {published data only}

Rhodes K, Lauderdale D, Stocking C, Howes D, Roizen M, Levinson W. Better health while you wait: a controlled trial of a computer‐based intervention for screening and health promotion in the emergency department. Annals of Emergency Medicine 2001;37(3):284‐91.

Rimer 1999 {published data only}

Rimer BK, Conaway M, Lyna P, Glassman B, Yarnall KSH, Lipkus I, et al. The impact of tailored interventions on a community health center population. Patient Education and Counseling 1999;37(2):125‐40.

Russell 2010 {published data only}

Russell KM, Champion VL, Monahan PO, Millon‐Underwood S, Zhao Q, Spacey N, et al. Randomized trial of a lay health adviser and computer intervention to increase mammography screening in African American women. Cancer Epidemiology Biomarkers and Prevention 2010;19:201‐10.

Schroy 2008 {published data only}

Schroy PC, Glick JT, Wilson S, Robinson PA, Heeran TC. An effective educational strategy for improving knowledge, risk perception and risk communication among colorectal adenoma patients. Journal of Clinical Gastroenterology 2008;42:708‐14.

Vernon 2011 {published data only}

Vernon SW, Bartholomew LK, McQueen A, Bettencourt JL, Greisinger A, Coan SP, et al. A randomized controlled trial of a tailored interactive computer‐delivered intervention to promote colorectal cancer screening: sometimes more is just the same. Annals of Behavioral Medicine 2011;41(3):284‐99.

Walker 2008 {published data only}

Walker EA, Schechter CB, Caban A, Basch CE. Telephone intervention to promote diabetic retinopathy screening among the urban poor. American Journal of Preventative Medicine 2008;34(3):185‐91.

Walsh 2010 {published data only}

Walsh JME, Salazar R, Nguyen TT, Kaplan C, Nguyen L, Hwang J, et al. Healthy Colon, Healthy Life: a novel colorectal cancer screening intervention. American Journal of Preventative Medicine 2010;39(1):1‐14.

Weber 1997 {published data only}

Weber B, Reilly B. Enhancing mammography use in the inner city: a randomized trial of intensive case management. Archives of Internal Medicine 1997;157:2345‐9.

Glenn 2011 {published data only}

Glenn BA, Herrmann AK, Crespi CM, Mojica CM, Chang LC, Maxwell AE, et al. Changes in risk perceptions in relation to self‐reported colorectal cancer screening among first‐degree relatives of colorectal cancer cases enrolled in a randomized trial. Health Psychology 2011;30(4):481‐91.

Lowery 2012 {published data only}

Lowery JT, Marcus AL, Kinney A, Bowen D, Finklestein DM, Horick N, et al. The family health promotion project (FHPP): Design and baseline data from a randomized trial to increase colonoscopy screening in high risk families. Contemporary Clinical Trials 2012;33:426‐35.

Ahmed 2012

Ahmed H, Naik G, Willoughby H, Edwards AG. Communicating risk. BMJ 2012;344:e3996.

Albada 2009

Albada A, Ausems MGEM, Bensing JM, van Dulmen S. Tailored information about cancer risk and screening: a systematic review. Patient Education and Counseling 2009;77(2):155‐71.

Barratt 1999

Barratt A, Irwig L, Glasziou P, Cumming RG, Raffle A, Hicks N, et al. Users' Guides to the Medical Literature XVII. How to Use Guidelines and Recommendations About Screening. Evidence‐Based Medicine Working Group. Journal of American Medical Association 1999;281(21):2029–34.

Barratt 2005

Barratt A, Edwards A, Trevena L, McCaffery K, Woloshin S, Bekker H, et al. Presenting probabilities. In: O’Connor A, Llewellyn‐Thomas H, Stacey D editor(s). IPDAS Collaboration Background Document. Draft VIII ed. IPDAS Collaboration, 2005:11‐16.

Barry 1997

Barry MJ, Cherkin D, Chang Y, Fowler C, Skates S. A randomized trial of a multimedia shared decision‐making program for men facing a treatment decision for benign prostatic hyperplasia. Disease Management and Clinical Outcomes 1997;1:5‐14.

Beauchamp 2001

Beauchamp T, Childress J. Principles of Biomedical Ethics. 5th Edition. Oxford: Oxford University Press, 2001.

Becker 1974

Becker MH. The Health Belief Model and Personal Health Behavior. San Francisco: Society for Public Health Education, 1974.

Bekker 1999

Bekker H, Thornton JG, Airey CM, Connelly JB, Hewison J, Robinson MB, et al. Informed decision making: an annotated bibliography and systematic review. Health Technology Assesment 1999;3(1):1‐156.

Bewley 2011

Bewley S. The NHS breast screening programme needs independent review. BMJ 2011;343:d6894.

Bonfill 2001

Bonfill X, Marzo M, Pladevall M, Martí J, Emparanza JI. Strategies for increasing the participation of women in community breast cancer screening. Cochrane Database of Systematic Reviews 2001, Issue 1. [DOI: 10.1002/14651858.CD002943]

Bottorff 1996

Bottorff JD, Ratner PA, Johnson JL, Lovato CY, Joab SA. Uncertainties and challenges: communicating risk in the context of familial cancer. Report to the National Cancer Institute of Canada. Vancouver: School of Nursing and Institute of Health Promotion Research, University of British Columbia, 1996.

Brawley 2012

Brawley O, Byers T, Chen A, Pignone M, Ransohoff D, Schenk M, et al. New American Cancer Society process for creating trustworthy cancer screening guidelines. JAMA 2012;306(22):2495‐9.

Briss 2004

Briss P, Rimer B, Reilley B, Coates R, Lee N, Mullen P, et al. Promoting informed decisions about cancer screening in communities and healthcare systems. American Journal of Preventive Medicine 2004;26(1):67‐80.

Cacioppo 1984

Cacioppo JT, Petty RE. The Elaboration Likelihood model of persuasion. Advances in Consumer Research 1984;11:673‐5.

Collins 2011

Collins RE, Lopez LM, Marteau TM. Emotional impact of screening: a systematic review and meta‐analysis. BMC Public Health 2011;11:603. [DOI: 10.1186/1471‐2458‐11‐603]

Covello 1986

Covello VT, von Winterfeldt D, Slovic P. Risk communication: a review of the literature. Risk Abstracts 1986;3(4):171‐81.

Deeks 2011

Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration, Updated March 2011. Available from www.cochrane‐handbook.org.

Edwards 1999a

Edwards AGK, Elwyn GJ. How should 'effectiveness' of risk communication to aid patients' decisions be judged? A review of the literature. Medical Decision Making 1999;19(4):428‐34.

Edwards 2003a

Edwards A, Elwyn G, Hood K, Robling M, Atwell C, Holmes‐Rovner M, et al. The development of COMRADE – a patient‐based outcome measure to evaluate the effectiveness of risk communication and treatment decision making in consultations. Patient Education and Counseling 2003;50(3):311‐22.

Elwyn 2000

Elwyn G, Edwards A, Kinnersley P, Grol R. Shared decision‐making and the concept of equipoise: defining the 'competences' of involving patients in health care choices. British Journal of General Practice 2000;50(460):892‐9.

Everett 2011

Everett T, Bryant A, Griffin MF, Martin‐Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Systematic Reviews 2011, Issue 5. [DOI: 10.1002/14651858.CD002834]

Fischhoff 1979

Fischhoff B, Slovic P, Lichtenstein S. Which risks are acceptable?. Environment 1979;21:17‐38.

Fishbein 1975

Fishbein M, Ajzen I. Belief, Attitude, Intention and Behaviour: An Introduction to Theory and Research. Reading, Massachusetts: Addison‐Wesley Publishing Company, Inc, 1975.

Flight 2004

Flight IHK, Wilson CL, Griffiths L, Myers RE. Interventions for improving uptake of population‐based screening for colorectal cancer using fecal occult blood testing. Cochrane Database of Systematic Reviews 2004, Issue 4. [DOI: 10.1002/14651858.CD005035]

Foster 1998

Foster P, Anderson CM. Reaching targets in the national cervical screening programme: are current practices unethical?. Journal of Medical Ethics 1998;24(3):151‐7.

Gail 1989

Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Journal of the National Cancer Institute 1989;81(24):1879‐86.

Ghosh 2005

Ghosh AK, Ghosh K. Translating evidence‐based information into effective risk communication: current challenges and opportunities. Journal of Laboratory and Clinical Medicine 2005;145(4):171‐80.

GMC 1998

The General Medical Council. Seeking patients' consent: the ethical considerations. London, United Kingdom: General Medical Council, 1998.

Guadagnoli 1998

Guadagnoli E, Ward P. Patient participation in decision‐making. Social Science & Medicine 1998;47(3):329‐39.

Guyatt 2008

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924‐6.

Gøtzsche 2011

Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews 2011, Issue 1. [DOI: 10.1002/14651858.CD001877.pub4]

Hackshaw 2012

Hackshaw A. Benefits and harms of mammography screening. BMJ 2012;344:d8279.

Heart 1999

British Cardiac Society, British Hyperlipidaemia Association, British Hypertension Society. Joint British recommendations on prevention of coronary heart disease in clinical practice. Heart 1999;80 (Supplement 2):S1‐S29.

Higgins 2011

Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration, Updated March 2011. Available from www.cochrane‐handbook.org.

Hippisley‐Cox 2008

Hippisley‐Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 2008;336:1475‐82.

Holland 2005

Holland W, Stewart S. Key issues in screening: genetics, information and economics. In: Holland W, Stewart S editor(s). Screening in Disease Prevention: What Works?. 1st Edition. Oxford: Radcliffe, 2005:17‐32.

Holmes‐Rovner 1996

Holmes‐Rovner M, Kroll J, Schmitt N, Rovner DR, Breer ML, Rothert ML, et al. Patient satisfaction with health care decisions: the satisfaction with decision scale. Medical Decision Making 1996;16(1):58‐64.

Jepson 2000

Jepson R, Clegg A, Forbes C, Lewis R, Sowden A, Kleijnen J. The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technology Assessment Programme, UK National Health Service2000; Vol. 4, issue 14.

Jepson 2005

Jepson R, Hewison J, Thompson A, Weller D. How should we measure informed choice? The case of cancer screening. Journal of Medical Ethics 2005;31:192‐6.

Kanis 2009

Kanis JA, Oden A, Johanssen H, Borgström F, Ström O, McCloskey E. FRAX® and its applications to clinical practice. Bone 2009;44:734‐43.

Keeney 1986

Keeney RL, von Winterfeldt D. Improving risk communication. Risk Analysis 1986;6(4):417‐24.

Kellar 2011

Kellar I, Mann E, Kinmonth AL, Prevost AT, Sutton S, Marteau TM. Can informed choice invitations lead to inequities in intentions to make lifestyle changes among participants in a primary care diabetes screening programme? Evidence from a randomized trial. Public Health 2011;125(9):645‐52.

Kreuter 1999a

Kreuter MW, Farrell DW, Olevitch LR, Brennan LK. Tailoring Health Messages: Customizing Communication with Computer Technology. New Jersey: Lawrence Erlbaum Associates, Inc, 1999.

Kreuter 1999b

Kreuter MW, Bull FC, Clark EM, Oswald DL. Understanding how people process health information: a comparison of tailored and nontailored weight‐loss materials. Health Psychology 1999;18(5):487‐94.

Liao 1996

Liao L, Jollis JG, DeLong ER, Peterson ED, Morris KG, Mark DB. Impact of an interactive video on decision making of patients with ischaemic heart disease. Journal of General Internal Medicine 1996;11(6):373‐6.

Lipkus 2007a

Lipkus IM. Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations. Medical Decision Making 2007;27(5):696‐713.

Llewelyn‐Thomas 1995

Llewellyn‐Thomas HA. Patients' health care decision‐making: a framework for descriptive and experimental investigations. Medical Decision Making 1995;15:101‐6.

Marteau 2001

Marteau TM, Dormandy E, Michie S. A multi‐dimensional measure of informed choice. Health Expectations 2001;4:99‐108.

Marteau 2002

Marteau TM, Kinmonth AL. Screening for cardiovascular risk: public health imperative or matter for individual informed choice?. BMJ 2002;325(7355):78‐80.

Matthews 1999

Matthews E, Edwards A, Barker J, Bloor M, Covey J, Hood K, et al. Efficient literature searching in diffuse topics: lessons from a systematic review of research on communicating risk to patients in primary care. Health Libraries Review 1999;16(2):112‐20.

McPherson 2010

McPherson K. Screening for breast cancer—balancing the debate. BMJ 2010;340:c3106.

Michie 2002

Michie S, Dormandy E, Marteau TM. The multi‐dimensional measure of informed choice: a validation study. Patient Education and Counseling 2002;48(1):87‐91.

Mullen 2006

Mullen PD, Allen JD, Glanz K, Fernandez ME, Bowen DJ, Pruitt SL, et al. Measures used in studies of informed decision making about cancer screening: a systematic review. Annals of Behavioral Medicine 2006;32(3):188‐201.

Naik 2012

Naik G, Ahmed H, Edwards AG. Communicating risk to patients and the public. British Journal of General Practice 2012;62(597):213‐6.

Nelson 2009

Nelson HD, Tyne K, Nalk A, Bougatsos K, Chan BK, Humphrey L. Screening for breast cancer: an update for the US Preventive Services Task Force. Annals of Internal Medicine 2009;151:727‐37.

NHS Information Centre 2011a

The NHS Information Centre. Breast Screening Programme, England 2009‐10 [Online]. Available at: http://www.ic.nhs.uk/webfiles/publications/008_Screening/Breastscrn0910/Breast_Screening_Publication_2010_Report.pdf 2011 (accessed on 12/02/2012).

NHS Information Centre 2011b

The NHS Information Centre. Cervical Screening Programme, England 2010‐11 [Online]. Available at: http://www.ic.nhs.uk/webfiles/publications/008_Screening/cervscreen1011/Cervical_Bulletin_2010_11_v1_1.pdf, 2011 (accessed on 12/02/2012).

Noar 2007

Noar SM, Benac CN, Harris MS, et al. Does tailoring matter? Meta‐analytic review of tailored print health behavior change interventions. Psychological Bulletin 2007;133(4):673‐93.

O'Connor 1995

O'Connor AM. Validation of a decisional conflict scale. Medical Decision Making 1995;15(1):25‐30.

Prochaska 1992

Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Progress in Behavior Modification 1992;28:183‐218.

Prochaska 1997

Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. American Journal of Health Promotion 1997;12(1):38‐48.

Raffle 2001

Raffle A. Information about screening ‐ is it to achieve high uptake or to ensure informed choice?. Health Expectations 2001;4:92‐8.

RCGP 2002

Royal College of General Practitioners. Fellowship by Assessment Handbook. 13th Edition. London: Royal College of General Practitioners, 2002.

Richards 2011

Richards M. Breast cancer screening; an independent review is under way. BMJ 2011;343:d6843.

Rogers 2002

Rogers W. Are guidelines ethical? Some considerations for general practice. British Journal of General Practice 2002;52(481):663‐8.

Rose 1978

Rose G, Barker DJ. Epidemiology for the uninitiated: screening. BMJ 1978;2(6149):1417‐8.

Rosenstock 1988

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Education Quarterly 1988;15(2):175‐83.

Rosenstock 2000

Rosenstock IM. Health Belief model. In: Kazdin , AE editor(s). Encyclopedia of Psychology. 4th Edition. Vol. 4, Washington DC: American Psychological Association; Oxford University Press, 2000:78‐80.

Sarfati 1998

Sarfati D, Howden‐Chapman P, Woodward, Salmond C. Does the frame affect the picture? A study into how attitudes to screening for cancer are affected by the way benefits are expressed. Journal of Medical Screening 1998;5:137‐40.

Slaytor 1998

Slaytor E, Ward JE. How risks of breast cancer and benefits of screening are communicated to women: analysis of 58 pamphlets. BMJ 1998;317:263‐4.

Stacey 2011

Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes‐Rovner M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2011, Issue 10. [DOI: 10.1002/14651858.CD001431]

Stefanek 2011

Stefanek M E. Uninformed Compliance or Informed Choice? A Needed Shift in our Approach to Cancer Screening. Journal of the National Cancer Institute 2011;103(24):1821‐26.

Stewart‐Brown 1997

Stewart‐Brown S, Farmer A. Screening could seriously damage your health [Editorial]. BMJ 1997;314:533.

Thomson 2005

Thomson R, Murtagh M, Khaw F. Tensions in public health policy: patient engagement, evidence‐based public health and health inequalities. Quality & Safety in Health Care 2005;14(6):398‐400.

UK National Screening Portal

UK National Screening Committee. UK Screening Portal (Online). Available at: http://www.screening.nhs.uk/programmes (accessed on 12/02/2012).

UKNSC 1998

UK National Screening Committee. First Report. Departments of Health for England, Scotland, Northern Ireland, and Wales web site, Available at http://www.dh.gov.uk 1998 (accessed on 12/02/2012).

UKNSC 2000

UK National Screening Committee. Second Report. Departments of Health for England, Scotland, Northern Ireland, and Wales web site, Available at http://www.dh.gov.uk. London, 2000 (accessed on 12/02/2012).

US PSTF 2005

US Preventive Services Task Force. Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: recommendation statement. Annals of Internal Medicine2005; Vol. 143:355‐61.

Vlek 1987

Vlek C. Risk assessment, risk perception and decision making about courses of action involving genetic risk: an overview of concepts and methods. Birth Defects: Original Article Series 1987;23(2):171‐207.

Weinstein 2002

Weinstein ND, Sandman PM. The precaution adoption process model. In: Glanz K, Rimmer BK, Lewis FM editor(s). Health Behaviour and Health Education: Theory, Research and Practice. 3rd Edition. San Francisco: Jossey‐Bass, 2002:121‐43.

Wilson 1968

Wilson JMG, Jungner G. Principles and Practice of Screening for Disease (Public Health Paper Number 34). Geneva: World Health Organisation, 1968.

References to other published versions of this review

Jump to:

Edwards 1999b

Edwards A, Hood K, Matthews E, Russell I, Wilkinson C. Personalised risk communication in health screening programs. Cochrane Database of Systematic Reviews 1999, Issue 4.

Edwards 2003b

Edwards A, Unigwe S, Elwyn G, Hood K. Effects of communicating individual risks in screening programmes: Cochrane systematic review. BMJ 2003;327(7417):703‐9.

Edwards 2003c

Edwards A, Unigwe S, Elwyn G, Hood K. Personalised risk communication for informed decision making about entering screening programs. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD001865]

Edwards 2006

Edwards AG, Evans R, Dundon J, Haigh S, Hood K, Elwyn GJ. Personalised risk communication for informed decision making about taking screening tests. Cochrane Database of Systematic Reviews 2006, Issue 4. [DOI: 10.1002/14651858.CD001865.pub2]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Jump to:

Bastani 1999

Methods

RCT

Participants

Women over 30; breast cancer in first degree relative; resident in USA or Canada. Number of participants included in the analysis = 753.

Interventions

Mailed personalised risk assessment notification and other theoretically driven (Adherence Model) materials tailored for high risk women.

Outcomes

Uptake of mammography one year after baseline survey.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

Authors do not mention blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

Authors do not mention blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Significant loss to follow‐up. 22% loss in the intervention arm and 11% loss in the control arm. Incomplete data were excluded from the analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol was not available but all outcomes in the methods section of the study were reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

High risk

Lower education levels in intervention group.

Measure against contamination

Low risk

Members of the same family received the same interventions.
Bloom 2006

Methods

RCT

Participants

Breast cancer screening in high risk women (those who have first degree relatives with breast cancer diagnosed at age < 50). Number of participants included in the analysis = 163.

Interventions

Telephone counselling.

Outcomes

Breast cancer worry, Achievement of more accurate risk perception, Improvements in health behaviours, breast cancer screening‐ mammography and clinical breast examination; six months post intervention.

Notes

Mammography adherence reported for women aged more that 40 years only.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

Authors do not mention blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

Authors do not mention blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat analysis done.

Selective reporting (reporting bias)

High risk

Study protocol was not available. Mammography adherence reported for women aged more that 40 years only.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Baseline demographic and behavioural characteristics not mentioned separately for control and intervention arms.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with breast cancer. They were recruited through the index cancer patients. There may be a high chance of contamination and authors do not mention any measures taken to prevent this.

Bodurtha 2009

Methods

RCT

Participants

Recruitment occurred in waiting rooms of four women’s health clinics in the Virginia Commonwealth University Health System in Richmond, Virginia, USA

Women eligible for the study were:

  • At least 40 years old

  • Not pregnant

  • Nonparticipants in the trial’s pilot study

  • Had no history of breast cancer or carcinoma in situ.

Number of participants included in the analysis = 899.

Interventions

Participants in the intervention group had 5‐year and lifetime probabilities for breast cancer using the Gail model. Information sheets for those in intervention groups provided this personalised risk detail and also addressed other traditional constructs of Health Belief Model. Nutrition and physical activity were also included.

Outcomes

  • Mammography uptake last 18 months

  • Breast self examination at least six times

  • Clinical breast examination

  • Breast screening intentions

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

A biostatistician prepared stratified (by clinic) block randomisation assignments before the study.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

Authors do not mention blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

Authors do not mention blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Analysis preserved the intention to treat.

Selective reporting (reporting bias)

Unclear risk

Study protocol was not available. All outcomes in the study methods section were reported.

Funding for the screening test

Low risk

Most participants had some form of medical insurance. Self pay participants in the control and intervention groups were comparable at baseline.

Baseline comparability

Low risk

Baseline characteristics were comparable.

Measure against contamination

Unclear risk

No information provided.
Bowen 2002

Methods

RCT

Participants

Women with first degree relative with breast cancer; Seattle, USA. Number of participants included in the analysis = 317.

Interventions

Individual or group‐based genetic counselling, including Gail and Claus scores.

Outcomes

Interest in having BRCA tests; perception of self as appropriate candidate for tests, measured at six months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Insignificant loss to follow‐up.

Selective reporting (reporting bias)

Unclear risk

Study protocol was unavailable. All stated outcomes in the methods section are reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Baseline characteristics of participants in each arm did not differ significantly.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with breast cancer. Some were recruited through the index cancer patients, others by newspaper advertisements. There may be a chance of contamination and authors do not mention any measures taken to prevent this.

Bowen 2006

Methods

RCT

Participants

Sexual minority women (lesbian and bisexual women) aged 18 to 75. Participants were recruited by announcements in lesbian and gay mailing lists and organisations, newspapers at sexual minority women's community centres and Gay and Lesbian Employee network.

Inclusion criteria:

  • Self‐identification as lesbian/bisexual

  • No personal history of breast/ovarian cancer

  • Family pedigree not indicative of predisposition to breast cancer

  • Willingness to complete surveys and participate in counselling

  • Number of participants included in the analysis = 150

  • Location Seattle, USA

Interventions

Breast cancer counselling including information on screening mammography, breast self examination, stress management and social support session. A personalised assessment of breast cancer risk based on Gail and Claus model was provided to the participants in intervention group.

Outcomes

Outcomes measured at 6 and 24 months were:

  • Screening uptake

  • Perceived risk

  • Cancer worry score

  • Mental health score

Notes

Data could not be used in our analysis, but study reports increase in screening uptake in those aged above 40 in the intervention group. Perceived risk and the anxiety associated with breast cancer decreased significantly in the intervention group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Low drop out rate in the study which is not significant. Those who dropped out of the study did not differ significantly in baseline characteristics.

Selective reporting (reporting bias)

High risk

Study protocol was not available. Uptake selectively reported for participants above age of 40. No mention of number of participants in these groups.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Unclear risk

No information provided.
Bowen 2010

Methods

RCT

Participants

Participants were recruited via telephone from purchased lists of women in general population in the Pacific Northwest. USA. Number of participants included in the analysis = 1366.

Interventions

Participants were divided into average risk (70% in total), mixed risk (25%) and genetic risk (5%) depending on risk factors for breast cancer, Gail score and level of cancer worry. They were provided with stepped care interventions depending on their category. Mail intervention for all in intervention group, which was then stepped up for other intervention strategies according to risk; for example, genetic counselling for genetic risk individuals.

Outcomes

Outcomes measured at one year were:

  • Mammography

  • Breast self examination

  • Genetic test interest

  • Quality of life (SF36 mental health scale)

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat principle has been used. There was no difference in the characteristics of participants who were followed up compared with those lost to follow up.

Selective reporting (reporting bias)

High risk

Study protocol not available. Some outcomes in methods section have not been reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Both study arms comparable at baseline.

Measure against contamination

Unclear risk

No information provided.
Campbell 1997

Methods

RCT

Participants

Women who had not had a cervical (Pap) smear in previous 30 months; New South Wales, Australia. Number of participants included in the analysis = 411.

Interventions

Computer generated printed feedback, listing 'risk factor' of not having a smear within past 2 years.

Outcomes

Uptake of cervical (Pap) smear was measured at 6 months

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

Randomisation was undertaken according to day of attendance at practice.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intervention was delivered immediately after recruitment and outcome ascertainment was carried out using self reporting and routinely collected data. There were no issues of loss to follow‐up.

Selective reporting (reporting bias)

Unclear risk

Study protocol not available. The only outcome measure was uptake of screening as mentioned in the study.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

No significant baseline difference between groups.

Measure against contamination

Low risk

Authors state randomisation by day of attendance was a measure against contamination.
Champion 1994

Methods

RCT

Participants

Women aged >= 35 ; never having had breast cancer. USA. Number of participants included in the analysis = 300.

Interventions

In‐home interviews conducted by graduate nursing research assistants. Discussion about individual risk factors ‐ susceptibility intervention ‐ as part of a belief modifying intervention.

Outcomes

Change in beliefs and knowledge (including susceptibility scores) post‐intervention; mammography compliance one year post‐intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Random digit dialling but no other information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Low attrition rate of 7%. Those who dropped out had moved their residence.

Selective reporting (reporting bias)

Unclear risk

Study protocol not available. All outcomes mentioned in the study have been reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

High risk

Much higher baseline compliance rate for mammography in intervention group.

Measure against contamination

Unclear risk

No measures reported.
Champion 1995

Methods

RCT

Participants

  • Women aged > = 35; not diagnosed with breast cancer.

  • USA. (Analysis of intervention effect only on those 40 years and over).

  • Number of participants included in the analysis = 405

Interventions

In‐home interviews conducted by graduate nursing students. Discussion about individual risk factors ‐ susceptibility intervention ‐ as part of a belief modifying intervention.

Outcomes

Change in beliefs and knowledge, including susceptibility (scores); mammography compliance; movement across stages of change were measured at one year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Low attrition rate of 7%. Those who dropped out had moved their residence.

Selective reporting (reporting bias)

High risk

Collected data for > 35 year olds but only reported for > 40 year olds.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Unclear how many participants in each arm were in stage 3 of adoption of screening.

Measure against contamination

Unclear risk

No measures reported.
Champion 2000a

Methods

RCT

Participants

Low‐income African American women aged 45 to 64; Indiana, USA. Number of participants included in the analysis = 278.

Interventions

In‐person tailored interventions based on Health Belief and Transtheoretical Models, including listing of susceptibility factors.

Outcomes

Screening mammography uptake at one year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer generated randomised sequence.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Low attrition rate of 11%. However authors do not give information on the reasons for this and the actual figures in each of the study arms. Incomplete data excluded from analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol not available. All outcomes mentioned in the study have been reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

No differences reported but very little data provided.

Measure against contamination

Unclear risk

No measures reported.
Champion 2002

Methods

RCT

Participants

Women aged over 50 not adherent to mammography recommendations; medical clinic at St Louis and HMO in Indianapolis, USA. Number of participants included in the analysis = 976.

Interventions

Tailored interventions based on Health Belief and Transtheoretical Models, including perceived risk and risk factors (e.g. age, family history).

Outcomes

Self‐reported mammography uptake at two months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Significant rate of attrition. This has not been clearly described. No mention of adjustments for missing data.

Selective reporting (reporting bias)

High risk

Study protocol not available. Not all outcomes addressed, sub‐group reporting.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

High risk

Baseline characteristics have not been described separately for each study arms.

Measure against contamination

Unclear risk

No measures reported.
Champion 2003

Methods

RCT

Participants

Women in the 51 to 84 years age range who have not received a mammogram in the last 15 months; from an HMO and general medicine clinic, USA. Number of participants included in the analysis = 773.

Interventions

Tailored interventions based on Health Belief and Transtheoretical Models, including listing of susceptibility factors.

Outcomes

Screening mammography uptake at six months to one year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer generated allocation sequence.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Insignificant attrition rate. However no reasons given for attrition and attrition rate in each of the study arms not explicit. Incomplete data excluded from analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. Outcome mentioned in the study has been reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

High risk

There are more African Americans in the control group.

Measure against contamination

Unclear risk

No measures reported.
Champion 2007

Methods

RCT

Participants

Participants recruited from two sites: A university‐affiliated general medicine clinic setting serving predominately low‐income clientele in St. Louis and a HMO comprised mainly of enrollees in Indianapolis, IN, USA. Number of participants included in the analysis = 1244.

Interventions

Computer‐tailored interventions addressed each woman’s perceived risk of breast cancer, benefits and/or barriers related to screening and self‐efficacy for obtaining mammography, and her knowledge of the mammography procedure.

Outcomes

Mammography adherence used for our review and forward stage movement (pre‐contemplation to contemplation, contemplation to action or pre‐contemplation to action) from baseline to 2 month post follow up.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No significant attrition.

Selective reporting (reporting bias)

Unclear risk

Study protocol not available. Outcomes mentioned in the study have been addressed.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

The study reports that there were no significant differences at baseline.

Measure against contamination

Unclear risk

No information provided.
Curry 1993

Methods

RCT

Participants

Women aged > = 50; newly enrolled in an HMO, without prior history of breast cancer or of mammography use in the previous 12 months. USA. Number of participants included in the analysis = 841.

Interventions

Mailed risk factor questionnaire plus personal risk invitation detailing personal risk factors.

Outcomes

Mammography use within 1 year of invitation.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat analysis has been used.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study have been reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Differences in response rates to baseline survey and rates of previous breast biopsy between study arms.

Measure against contamination

Unclear risk

No measures reported.
Geller 2006

Methods

RCT

Participants

Siblings of melanoma patients living in the USA were approached to participate in the study. Patients were recruited from the Boston area teaching hospital dermatology clinics, within a month after diagnosis of melanoma. Participants were at least 18 years of age with no previous history of skin cancer. Number of participants included in the analysis = 494.

Interventions

The intervention drew on a number of psychosocial theories of health behaviour change, including Social Cognitive Theory, Theory of Planned Behaviour, The Health Belief Model, The Precaution Adoption Model, and The Transtheoretical Model. Intervention condition participants received an initial motivational and goal‐setting telephone intervention session delivered by the health educator. Thereafter computer‐generated tailored print materials were sent at 1, 3, and 5 months after randomization.

Outcomes

Having skin cancer screen by dermatologist, personal examination of moles and use of sun protection at one year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

Alternate patient groups used.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Significant loss to follow‐up. No mention of any adjustments or intention‐to‐treat principle.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study analysed/reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

All study arms were comparable at baseline.

Measure against contamination

Low risk

Cluster randomised study.
Glanz 2007

Methods

RCT

Participants

First degree relatives of colorectal cancer from Hawaii, USA. Number of participants included in the analysis = 176.

Interventions

Intervention included personal risk and culturally tailored intervention.

Outcomes

Primary outcome was adherence to screening at one year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Adjustment done in analysis. Reasons for attrition given.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study were reported.

Funding for the screening test

Low risk

98.3% had health insurance. Insurance status was comparable at baseline.

Baseline comparability

Low risk

All study arms were comparable at baseline.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with colorectal cancer. They were recruited through the index cancer patients. There may be a high chance of contamination and authors do not mention any measures taken to prevent this.

Glazebrook 2006

Methods

RCT

Participants

Participants were recruited from Family Practices within Nottinghamshire, England. Number of participants included in the analysis = 589.

Interventions

Multimedia programme called "Skinsafe" with eight sections designed to be completed in 10 to 15 minutes was used. It included animation, photographs and simple text to inform users about the dangers from excessive sun exposure; how to protect skin from the sun; characteristics of skin at risk; early signs of melanoma; how to reduce risk from melanoma; how to check skin for suspicious lesions. The last section was designed to provide individualised feedback on the persons relative risk for skin cancer (melanoma). Health Belief Model was used to base the intervention.

Outcomes

Knowledge, skin protective behaviour, perceived risk and screening uptake measured at six months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Coin toss.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Significant loss to follow‐up. Missing values were replaced by baseline values ‐ perhaps retains intention‐to‐treat principle

Selective reporting (reporting bias)

High risk

Study protocol unavailable. Perceived risk not fully reported

Funding for the screening test

Low risk

National Health Service funded.

Baseline comparability

Low risk

Study arms were comparable at baseline.

Measure against contamination

Low risk

Cluster randomised.
Helmes 2006

Methods

RCT

Participants

Participants were recruited from the Washington State Physicians' Networks' computerized database. They were aged 18 to 64; had no personal history of breast or ovarian cancer, or of genetic counselling  or testing for cancer risk; and were able to speak and write English. All participants who did not refuse were called to complete a brief eligibility survey by phone and then were mailed a baseline survey. If participants returned the survey and gave written consent, they were then randomised to one of the counselling conditions or the control group. Number of participants included in the analysis = 335.

Interventions

This study measured the effects of an intervention (individualised Gail risk score) in person and by telephone, compared to a control group.

Outcomes

Cancer worry, breast health intentions, perceived risk and intention to take up genetic testing measured at three months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat principle used. Reasons for drop outs given.

Selective reporting (reporting bias)

Unclear risk

Study protocols unavailable. All outcomes mentioned in the study were addressed.

Funding for the screening test

Low risk

All participants had health insurance

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Unclear risk

No information provided
Hutchison 1998

Methods

RCT

Participants

Patients aged 20 to 69 years, from two Canadian primary care group practices. Number of participants included in the analysis = 3152.

Interventions

Risk appraisal questionnaire (yielding risk score). Those with scores above 2 advised to go for screening.

Outcomes

Rate of cholesterol testing during the three months of follow up.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Significant loss to follow‐up. Incomplete data excluded from analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol not available. All outcomes mentioned in the study reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

High risk

Greater proportion of high‐risk patients in control group.

Measure against contamination

Low risk

Randomised by household unit.
Jibaja‐Weiss 2003

Methods

RCT.

Participants

Women registered at 2 urban community health centres; Houston, USA. Number of participants included in the analysis = 1483.

Interventions

Personalised letter, tailored for risk factor data and giving screening recommendations.

Outcomes

Scheduling and uptake of cervical (Pap) smear test and mammogram measured at one year after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer generated random number assignment.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Participants and service providers blinded.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

Unclear if outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Intervention in the form of postal letters could not be delivered (reason not known) to a significant number of recruits in the intervention arms. These were not accounted for in the analysis.

Selective reporting (reporting bias)

High risk

Study protocol unavailable. Data on breast cancer collected from 18 to 64 year olds but only reported for > 40 year olds.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

No significant differences between groups at baseline.

Measure against contamination

Unclear risk

No measures reported.
Kreuter 1996

Methods

RCT

Participants

Patients aged 18 to 75 from 8 family medical practices, North Carolina, USA. Number of participants included in the analysis = 1131.

Interventions

Mailed HRA (Health Risk Appraisal) ‐ risk information tailored to information given at baseline questionnaire.

Outcomes

Rate of Pap smear, mammography and cholesterol uptake after six months in those contemplating these behaviours at baseline.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

14% loss to follow‐up. No differences in attrition rates in the two intervention arms, but we are unclear about how this compares to the attrition rate in the control arm.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

No significant differences in baseline characteristics.

Measure against contamination

Unclear risk

No measures reported
Lee 1991

Methods

RCT, stratified for previous screening history and risk status.

Participants

Federal employees aged > = 40 years. USA. Number of participants included in the analysis = 278.

Interventions

Colorectal cancer risk appraisal ‐ categorised as high, medium or low personal risk.

Outcomes

Knowledge, intention to take test, and uptake measured at three months after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Random number table.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Similar loss to follow‐up in either of the study arms and low attrition rates.

Selective reporting (reporting bias)

High risk

Study protocol was not available. Outcomes mentioned not fully reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Differences between family history and fat consumption between groups but authors controlled for this in analysis.

Measure against contamination

Unclear risk

None reported.
Lerman 1995

Methods

RCT

Participants

Women aged 35 years and older with a family history of breast cancer in a first degree relative. USA. Number of participants included in the analysis = 239.

Interventions

Breast cancer risk counselling including discussion of factors contributing to elevated risk and presentation of individualized risk data.

Outcomes

Changes/improvement in risk comprehension.

Notes

Additional paper (Lerman 1996) addresses effects on general and breast cancer‐specific distress measured at three months after intervention.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors report blinding of randomisation personnel only.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

The authors report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

12% loss to follow‐up. However it is not clear as to the number of drop outs in each of the study arms. No mention of adjustment/intention‐to‐treat analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Unclear. There were significant baseline differences. However these were attempted to be controlled at the analysis stage.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with breast cancer. They were recruited through the index cancer patients. There may be a high chance of contamination and authors do not mention any measures taken to prevent this.

Lerman 1997

Methods

RCT

Participants

Women aged 18 to 75 who had at least one first degree relative with breast and/or ovarian cancer. USA. Number of participants included in the analysis = 320.

Interventions

Educational session including a review of individual risk factors for breast and ovarian cancers.

Outcomes

Changes in risk perception; testing intentions (breast cancer gene testing) measured at one month after intervention.

Notes

No data on taking test in control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

9% loss to follow‐up. However it is not clear as to the number of drop outs in each of the study arms. No mention of adjustment/intention‐to‐treat analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study reported.

Funding for the screening test

Unclear risk

Unclear, may have different sources as recruitment was by identifying relatives of index patients with cancer and self referrals.

Baseline comparability

Low risk

Study arms comparable at baseline.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with breast cancer. They were recruited through the index cancer patients. There may be a high chance of contamination and authors do not mention any measures taken to prevent this.

Lipkus 2005

Methods

RCT (2 x 2 factorial with basic versus more comprehensive information as well as personalised (tailored) versus non‐personalised).

Participants

99% male, New Jersey Carpenters' Fund members; aged over 50 years. Number of participants included in the analysis = 860.

Interventions

Tailored risk information with information about risk factors for colorectal cancer derived from baseline questionnaire.

Outcomes

Faecal Occult Blood Test (FOBT) uptake at one, two and three years after intervention.

Notes

Also assessed 'attributions of colorectal cancer risk' but not as risk perceptions directly affected by interventions.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat principle used.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study were addressed adequately.

Funding for the screening test

Low risk

FOBT kits were provided by the research group.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Unclear risk

No information provided.
Lipkus 2007b

Methods

RCT

Participants

Participants were recruited by newspaper adverts in Orange, Durham and Wake counties of North Carolina, USA. Subjects were included if they did not have a history of colorectal cancer, were 50 to 75 years of age, had never had a colonoscopic/sigmoidoscopic examination and not had an FOBT in the last 2 years. Number of participants included in the analysis = 160.

Interventions

Participants were first stratified to high and low colorectal cancer risk groups and were then randomised to the three study groups ‐ Control, Absolute risk only and Absolute + Comparative risk groups. All groups received general information on basic facts about colorectal cancer. The Absolute risk group were provided with a list of risk factors that were relevant to them. The Comparative + Absolute risk groups also received information on if their number of risk factors was high or low compared to the average number of risk factors for the population their geographical area, age and sex groups. Health Belief Model used to base the constructs.

Outcomes

  • Primary: Perceived absolute and comparative risks, attitudinal ambivalence, screening intention, Negative Emotions About Getting colorectal cancer (Worry), Perceived Severity of colorectal cancer.

  • Secondary: Return of FOBT.

  • Outcomes were measured within a month after intervention.

Notes

The primary outcomes have not been included in the meta‐analysis due to inadequate statistical details.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No drop out. Two errors dealt with appropriately.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study were reported.

Funding for the screening test

Low risk

FOBT was free of charge. Participants were paid $40 for taking part in the test.

Baseline comparability

Low risk

Study arms were comparable at baseline.

Measure against contamination

Unclear risk

No information provided.
Manne 2009

Methods

Cluster RCT.

Participants

Participants were siblings of (index) patients recruited from the oncology, gastroenterology, and surgical practices at 26 participating medical centres’ located across the USA (sites contributed 1 to 93 participants). Prospective patients were identified from tumour registries or medical records. Age of participants was < 35 years or < than 10 years younger that the age of diagnosis in the index patient. Number of participants included in the analysis = 412.

Interventions

Interventions for control group was generic educational print material used by Centre for Disease Control for prevention of colorectal cancer. There were two intervention groups. One group was provided with tailored print material including list of personal risk factors and the other group had the tailored print material along with telephone counselling.

Outcomes

Adherence to colorectal screening programme and the effect of mediators (decisional balance) on adherence measured at six months after intervention.

Notes

We have compared generic print group with tailored print group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Reasons for drop‐outs mentioned. Intention‐to‐treat analysis used.

Selective reporting (reporting bias)

High risk

Study protocol unavailable. Several outcomes mentioned in the study are not reported.

Funding for the screening test

Low risk

Most participants were covered by health insurance.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Low risk

Randomisation done by family.
Manne 2010

Methods

RCT.

Participants

First degree relatives of patients with skin cancer, with additional risk factors; aged over 20. Number of participants included in the analysis = 443.

Interventions

Tailored interventions with print material and telephone counselling, including personalised list of risk factors.

Outcomes

Uptake of screening, self skin examination and adopting sun protection habits measured at six months post intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat used. Reasons for attrition given.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Low risk

Most people had health insurance. Health insurance status comparable in both study arms.

Baseline comparability

Low risk

Comparable at baseline.

Measure against contamination

Low risk

Randomisation done by family.
Marcus 2005

Methods

RCT

Participants

Callers to one of nine participating regional Cancer Information Service offices in the USA. Number of participants included in the analysis = 2224.

Interventions

Tailored print materials were tested for efficacy in promoting colorectal cancer. Transtheoretical and Health Belief Model used to draw behavioural constructs.

Outcomes

Screening adherence at 14 months after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Attrition described and intention‐to‐treat analysis used.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Unclear risk

Unclear risk. No mention of insurance status/funding for the screening test.

Baseline comparability

Low risk

Comparable at baseline.

Measure against contamination

Unclear risk

No measures mentioned.
Myers 1999

Methods

RCT

Participants

African American men, aged 40 to 70 years. Patients at the University of Chicago, USA. Number of participants included in the analysis = 413.

Interventions

A personalised 'ProRecord' which included a tailored risk factors and symptoms form.

Outcomes

'Adherence', i.e. men who made an office visit for prostate cancer education and early detection within a year.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

The follow‐up surveys were carried out by an external agency. It is unlikely that participants were aware of the intervention group allocation.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No loss to follow‐up after assignment to intervention and control arms.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Unclear risk

Unclear risk. No mention of insurance status/funding for the screening test.

Baseline comparability

Unclear risk

No information provided.

Measure against contamination

Unclear risk

No information provided.
Nagle 2008

Methods

RCT

Participants

Pregnant women aged > 18 years and less than 12 weeks gestation. Number of participants included in the analysis = 339.

Interventions

Decision aid for prenatal testing of foetal abnormalities to improve women’s informed decision making. Decision aid included individual age‐related risk report.

Outcomes

  • Primary outcomes: informed choice, decisional conflict

  • Secondary outcomes: State‐Trait Anxiety Inventory, depression scale, attitudes to pregnancy and attitudes to foetus.

Outcomes were measured within 14 weeks of intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer generated random numbers by an independent statistician.

Allocation concealment (selection bias)

Low risk

Allocation was concealed.

Blinding of participants and personnel (performance bias)
All outcomes

High risk

Study reports that it was not possible to blind personnel and the participants.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Intention‐to‐treat analysis used.

Selective reporting (reporting bias)

Low risk

Study protocol available. All outcomes adequately reported.

Funding for the screening test

Unclear risk

Some screening tests were public funded depending on maternal age and others had private insurance.

Baseline comparability

Low risk

Study arms were comparable at baseline.

Measure against contamination

Low risk

Cluster randomised.
Rawl 2008

Methods

RCT

Participants

First degree relatives aged 40 and above of colorectal cancer survivors. Participants were able to read English; no personal colorectal cancer history; had not been screened for colorectal cancer according to American Cancer Society guidelines for screening. Number of participants included in the analysis = 140.

Interventions

Personalised versus general print intervention detailing colorectal cancer risk and recommendations for screening.

Outcomes

Uptake of screening (FOBT or sigmoidoscopy or colonoscopy) and change in stage of adoption for screening three months after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Authors state 'Computer randomisation', no further details provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

208 subjects were randomised. 177 completed baseline interview. However further 37 subjects were disqualified as 'ineligible' at this stage leaving a total of 140. Loss is higher in the intervention arm.

Selective reporting (reporting bias)

Unclear risk

Study protocol was unavailable. All outcome mentioned in the study were reported.

Funding for the screening test

Low risk

Participants given $20 gift voucher upon completion of data collection. Participants were insured.

Baseline comparability

Low risk

Groups were comparable at baseline.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with colorectal cancer. They were recruited through the index cancer patients. There may be a high chance of contamination and authors do not mention any measures taken to prevent this.

Rimer 2002

Methods

RCT

Participants

Women aged in their 40s and 50s, and members of Blue Cross and Blue Shield, North Carolina, USA. Number of participants included in the analysis = 1091.

Interventions

Tailored print materials detailing a woman's personal risk (numerical and graphical) of breast cancer based on Gail score.

Outcomes

Knowledge, accuracy of risk perceptions; mammography uptake measured at one year after intervention.

Notes

Tailored print + telephone counselling arm excluded as different and extra content.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Significant loss to follow‐up. Missing data were excluded from the analysis.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Study arms were comparable at baseline.

Measure against contamination

Unclear risk

None reported.
Saywell 1999

Methods

RCT

Participants

Women 50 to 85 years; non‐compliant with mammography guidelines; no history of breast cancer, USA. Number of participants included in the analysis = 808.

Interventions

Telephone and in‐person counselling including discussion of personal risk factors.

Outcomes

Mammography compliance 4 to 6 weeks after counselling.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

High risk

14% loss to follow‐up. Considerably higher loss in the control arm compared to the intervention groups of interest in this review (33/143 in control and 14/251 in intervention arm). No adjustments made for the loss to follow‐up.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study were reported.

Funding for the screening test

Low risk

Participants belonged to an HMO in the USA.

Baseline comparability

Low risk

Groups comparable at baseline.

Measure against contamination

Unclear risk

None reported.
Schwartz 1999

Methods

RCT

Participants

Women with family history of breast cancer (first degree relative of sufferer) aged 40 years and older. USA. Number of participants included in the analysis = 508.

Interventions

Risk counselling including individualised risk figures.

Outcomes

Self‐reported mammography use one year after (compared to baseline).

Notes

This is a follow‐up to the Lerman 1995 trial.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

Participants were blinded up to the point of intervention delivery. It may be difficult to blind the personnel but no information is provided.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

The authors report blinding of outcome assessors at follow‐up interview.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Significant loss to follow‐up. Intention‐to‐treat analysis done with no significant differences in results.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study are reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Unclear risk

Baseline characteristics differed amongst control and intervention groups but authors state they controlled for differences in analysis.

Measure against contamination

High risk

The participants were relatives of those who were diagnosed with breast cancer. They were recruited through the index cancer patients. There may be a chance of contamination within the family and authors do not mention any measures taken to prevent this.

Sequist 2011

Methods

RCT

Participants

Patients (age range 50 to 75 years) of 174 primary care physicians at 14 health centres who had a visit with a Harvard Vanguard Medical Associates primary care physician during the prior 18 months, and an active personal health record account, USA. Number of participants included in the analysis = 1103.

Interventions

Electronic patient messages and personalized risk assessments delivered via an electronic personal health record.

Outcomes

Screening uptake at one and four months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No loss to follow‐up.

Selective reporting (reporting bias)

Low risk

Study protocol was available. All outcomes reported adequately.

Funding for the screening test

Low risk

Most participants had some form of insurance and insurance status was comparable at baseline.

Baseline comparability

Low risk

Study participants comparable at baseline.

Measure against contamination

Unclear risk

None reported.
Skinner 1994

Methods

RCT, stratified between clinics.

Participants

Female family practice attenders aged 40 to 65 years. USA. Number of participants included in the analysis = 435.

Interventions

Tailored text about beliefs, mammography stages, risk factors and barriers.

Outcomes

Mammography stage and uptake measured at eight months after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

11% drop out rate, no information on spread of loss of follow‐up across the study arms.

Selective reporting (reporting bias)

High risk

Some of the outcomes mentioned in the study were not reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Baseline characteristics comparable.

Measure against contamination

Unclear risk

None reported.
Skinner 2002

Methods

RCT

Participants

Women with personal and family history of breast and/or ovarian cancer; North Carolina, USA. Number of participants included in the analysis = 262.

Interventions

Tailored print materials about cancer, risk factors, genes and genetic testing and risk quartile in verbal or verbal and numerical format according to woman's preference.

Outcomes

Knowledge, anxiety, accuracy of perceived risk and intention to take genetic test.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information provided.

Allocation concealment (selection bias)

Unclear risk

No information provided.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

16% drop out rate and equal in both study arms.

Selective reporting (reporting bias)

Unclear risk

Study protocol unavailable. All outcomes mentioned in the study were reported.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

No differences between groups.

Measure against contamination

Unclear risk

None reported.
Smith 2010

Methods

RCT

Participants

Participants were aged 55 to 64 years; speaking mainly English; average or slightly above average colorectal cancer risk; and low educational attainment. Potential participants were randomly drawn from the New South Wales electoral register, using the Australian Bureau of Statistics 'Socio‐Economic Index for Area' codes to target areas identified as socio‐economically disadvantaged (low educational attainment, high unemployment, and unskilled occupations). Number of participants included in the analysis = 572.

Interventions

Intervention was in form of decision aids for colorectal cancer screening. Participants in the intervention group received a paper based booklet and DVD (with or without a question prompt list) that had been designed for adults with low education and literacy skills. The aid contained an interactive exercise for the reader to identify his or her risk factor.

Outcomes

Primary outcomes: Informed choice, knowledge, screening attitudes and behaviour, and involvement preferences in screening decision

Secondary: Decision conflict, decision satisfaction, anxiety (STAI), cancer worry and uptake of test measured at two weeks after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Random permuted blocks of size 6 and 9 for each sex stratum. A statistician who had no contact with participants generated this randomisation list.

Allocation concealment (selection bias)

Low risk

Interviewers were unaware of allocation. Due to the nature of the intervention it is not possible to blind the participants of the allocation and allocation concealment was done as best as possible.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Interviewers at baseline interview were blind.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

It was not possible to blind interviewers at follow‐up interview, but questions with standardised wordings and pre‐coded responses were used within a supervised environment.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Reasons for missing data reported and dealt with at analysis stage. Intention‐to‐treat principle used.

Selective reporting (reporting bias)

Low risk

Study protocol was available. All outcomes are reported.

Funding for the screening test

Low risk

Screening kits were provided with the intervention packs.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Unclear risk

No information provided.
Steckelberg 2011

Methods

RCT

Participants

The study recruited people insured by a large German statutory health insurance scheme, the Gmünder ErsatzKasse (GEK), who were members of the target group for colorectal cancer screening in Germany (age 50 to 75, no history of colorectal cancer). Number of participants included in the analysis = 1586.

Interventions

Evidence based brochure with listing of risk factors were provided to the participants. Internet modules with information based on UKMRC framework for complex interventions were also a part of the interventions.

Outcomes

Primary: Informed consent (Marteau).

Secondary: Knowledge, uptake of screening and planned uptake of screening.

Outcomes were measured at six weeks after intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated random sequence.

Allocation concealment (selection bias)

Low risk

Allocation was concealed. Identity numbers were independent of allocation and study members did not have access to data.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Trial staff who sent out questionnaires and reminder letters and entered data were unaware of the study arm to which participants had been assigned, as was the statistician.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

Trial staff who sent out questionnaires and reminder letters and entered data were unaware of the study arm to which participants had been assigned, as was the statistician.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Low risk. Intention‐to‐treat principle used at analysis.

Selective reporting (reporting bias)

Low risk

Study protocol available. All outcomes adequately reported.

Funding for the screening test

Low risk

All participants were members of statutory insurance scheme.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Low risk

People in same family given same intervention.
Trevena 2008

Methods

RCT

Participants

List of patients between the ages of 50 and 74 years from general practice databases, New South Wales, Australia. Number of participants included in the analysis = 271.

Interventions

Self administered mailed decision aid with personalised risk component versus general information for colorectal cancer screening

Outcomes

Primary outcomes: adequate knowledge, clear values and screening intention (decision) at 4 months post intervention.

Secondary outcomes self‐reported FOBT uptake, the Ottawa acceptability scale, short‐form state anxiety scale (not fully published), full decisional conflict scale (not fully published) and self‐efficacy scale, measured at one month.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Sequential ID numbers randomly assigned using computer programme.

Allocation concealment (selection bias)

Low risk

Allocation was concealed via password protected programme.

Blinding of participants and personnel (performance bias)
All outcomes

Unclear risk

The authors do not report blinding of participants and/or personnel.

Blinding of outcome assessment (detection bias)
All outcomes

Unclear risk

The authors do not report blinding of outcome assessors.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

14% attrition and equal in both arms.

Selective reporting (reporting bias)

High risk

Study protocol available, but had inadequate details for outcome measures. Some of the secondary outcomes mentioned in the study were not reported fully.

Funding for the screening test

Unclear risk

No information provided.

Baseline comparability

Low risk

Participants were comparable at baseline.

Measure against contamination

Unclear risk

No information provided.

FOBT: Faecal Occult Blood Test

HMO: Health Maintenance Organization

RCT: randomised controlled trial

USA: United States of America

Characteristics of excluded studies [ordered by study ID]

Jump to:

Study

Reason for exclusion

Alexander 1996

A one group pre‐test and post‐test design. No control group.

Arimori 2006

This was an evaluation of decision guide with no communication or classification of risk.

Champion 2000b

Not personalised risk elements despite some attention to susceptibility; personalisation is for transtheoretical stage.

Champion 2006b

Intervention was tailored to Health Belief Model constructs rather that to risk.

Chan 2011

Interventions were delivered in group settings and did not involve personalised risk communication.

Costanza 2007

This was evaluation of motivational interviewing rather than risk communication.

Dignan 1996

Individualised counselling based on each woman's barriers to obtaining cervical screening, but not estimating her personal level of risk or risk factors.

Engelstad 2005

Intervention for follow‐up of abnormal Pap smears, not screening.

Gagnon 1996

Intervention involved counselling in which an estimate of a woman's risk of developing breast cancer was given, but no control group present; and main behavioural outcome was not mammography but breast self‐examination.

Giles 2001

Personalised risks given, but no control group for this pre‐post study.

Jerant 2007

Intervention was tailored to Health Belief Model constructs rather that to risk.

Kadison 1998

No control group.

Kreuter 2005

Tailoring for beliefs and cultural adaptation but not of risk information itself.

Leigh 1991

A longitudinal study, with risk calculated after cardiovascular screening.

Lipkus 2000

Tailored print and counselling, but no clear evidence that personalised risk information was given.

Miller 2005

Patient initiated call for information, consideration of testing; not screening.

Misra 2011

Intervention tailored towards participants health beliefs with no personalisation of risk.

Myers 2007

Intervention was tailored to Health Belief Model constructs rather that to risk.

Ockhuysen‐Vermey 2008

This was a protocol with no data.

Pye 1988

Identified from the Jepson review as being a 'risk factor assessment study'; but questionnaire assessed symptoms and not risk factors as such.

Rakowski 1998

Stage (of change) matched intervention but not explicitly dealing with individually calculated risk estimates.

Rhodes 2001

Personal health recommendations but not risk communication in screening. Process measures and no outcomes.

Rimer 1999

A tailored intervention, but not with regards to personal risks.

Russell 2010

Intervention was tailored to Health Belief Model constructs rather that to risk.

Schroy 2008

This study did not address screening.

Vernon 2011

Intervention was tailored to behaviour theoretical constructs rather that to risk.

Walker 2008

Risk was not personalised in this study.

Walsh 2010

Intervention was tailored to Health Belief Model constructs rather that to risk.

Weber 1997

Structured outreach, with identification and removal of barriers to care, but not estimating her personal level of risk or risk factors.

Characteristics of ongoing studies [ordered by study ID]

Jump to:

Glenn 2011

Trial name or title

Changes in risk perceptions in relation to self‐reported colorectal cancer screening among first‐degree relatives of colorectal cancer cases enrolled in a randomized trial.

Methods

RCT

Participants

People with colorectal cancer, identified through the California Cancer Registry, were contacted and invited to refer their first‐degree relatives to the study.

Interventions

Print booklet with information on colorectal cancer and screening, with a personalised risk assessment based on actual risk information assessed during baseline interview.

Outcomes

Changes in self‐reported perceived risk in relation to screening behaviour

Starting date

Not known

Contact information

Beth A Glenn

Division of Cancer Prevention and Control Research,

School of Public Health and Jonsson Comprehensive Cancer Centre,

University of California, Los Angeles, CA 90095‐6900, United States.

email: [email protected]

Notes

This is a secondary analysis of data. The manuscript for the primary study 'Increasing colorectal cancer screening with a sample of ethnically‐diverse first‐degree relatives of Colorectal cancer cases' has not yet been published.

Lowery 2012

Trial name or title

The Family Health Promotion Project (FHPP): design and baseline data from a randomized trial to increase colonoscopy screening in high risk families.

Methods

RCT

Participants

Participants were recruited from eight Colorectal Family Register (CFR) and four Cancer Genetics Network (CGN) registry sites.

Interventions

Interventions are grounded in several behaviour change theoretical models and delivered via motivational interviewing counselling framework.

Outcomes

Adherence to risk appropriate colonoscopic screening in high‐risk individuals.

Starting date

Not known

Contact information

Jan T. Lowery

University of Colorado Cancer Centre,

Anschutz Medical Campus,

Bldg 500, MS F‐538, PO Box 6508, Aurora, CO 80045‐0508, United States.

email: [email protected]

Notes

Data and analyses

Open in table viewer
Comparison 1. personalised risk communication versus general risk information

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

3

2444

Odds Ratio (Fixed, 95% CI)

4.48 [3.62, 5.53]
Analysis 1.1
Comparison 1 personalised risk communication versus general risk information, Outcome 1 Informed decision.

Comparison 1 personalised risk communication versus general risk information, Outcome 1 Informed decision.

1.1 calculated risk score (numerical) v general information

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]

1.2 personal risk factor list v general information

2

2106

Odds Ratio (Fixed, 95% CI)

4.98 [3.97, 6.24]

2 knowledge regarding screening test / condition concerned Show forest plot

4

Std. Mean Difference (Fixed, 95% CI)

Subtotals only
Analysis 1.2
Comparison 1 personalised risk communication versus general risk information, Outcome 2 knowledge regarding screening test / condition concerned.

Comparison 1 personalised risk communication versus general risk information, Outcome 2 knowledge regarding screening test / condition concerned.

2.1 calculated risk score (numerical) v general information

1

588

Std. Mean Difference (Fixed, 95% CI)

0.40 [0.23, 0.56]

2.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Fixed, 95% CI)

0.57 [0.32, 0.82]

2.3 personal risk factor list v general information

2

838

Std. Mean Difference (Fixed, 95% CI)

0.89 [0.75, 1.04]

3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge Show forest plot

3

Odds Ratio (Random, 95% CI)

Subtotals only
Analysis 1.3
Comparison 1 personalised risk communication versus general risk information, Outcome 3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

Comparison 1 personalised risk communication versus general risk information, Outcome 3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

3.1 calculated risk score (numerical) v general information

3

1413

Odds Ratio (Random, 95% CI)

2.60 [1.27, 5.34]

4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge Show forest plot

2

2107

Odds Ratio (Fixed, 95% CI)

7.13 [5.79, 8.79]
Analysis 1.4
Comparison 1 personalised risk communication versus general risk information, Outcome 4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

Comparison 1 personalised risk communication versus general risk information, Outcome 4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

4.1 personal risk factor list v general information

2

2107

Odds Ratio (Fixed, 95% CI)

7.13 [5.79, 8.79]

5 accurately perceived risk Show forest plot

3

1264

Odds Ratio (M‐H, Random, 95% CI)

1.65 [0.96, 2.81]
Analysis 1.5
Comparison 1 personalised risk communication versus general risk information, Outcome 5 accurately perceived risk.

Comparison 1 personalised risk communication versus general risk information, Outcome 5 accurately perceived risk.

5.1 calculated risk score (numerical) v general information

2

1004

Odds Ratio (M‐H, Random, 95% CI)

1.22 [0.91, 1.64]

5.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Random, 95% CI)

2.50 [1.48, 4.20]

6 perceived risk ‐ perceiving self as appropriate candidate for test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.6
Comparison 1 personalised risk communication versus general risk information, Outcome 6 perceived risk ‐ perceiving self as appropriate candidate for test.

Comparison 1 personalised risk communication versus general risk information, Outcome 6 perceived risk ‐ perceiving self as appropriate candidate for test.

6.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

6

1848

Std. Mean Difference (Random, 95% CI)

‐0.13 [‐0.29, 0.03]
Analysis 1.7
Comparison 1 personalised risk communication versus general risk information, Outcome 7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Comparison 1 personalised risk communication versus general risk information, Outcome 7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

7.1 calculated risk score (numerical) v general information

4

1058

Std. Mean Difference (Random, 95% CI)

‐0.19 [‐0.42, 0.04]

7.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Random, 95% CI)

0.0 [‐0.24, 0.24]

7.3 personal risk factor list v general information

1

530

Std. Mean Difference (Random, 95% CI)

‐0.02 [‐0.20, 0.16]

8 decision conflict (proportion with lower scores) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.8
Comparison 1 personalised risk communication versus general risk information, Outcome 8 decision conflict (proportion with lower scores).

Comparison 1 personalised risk communication versus general risk information, Outcome 8 decision conflict (proportion with lower scores).

8.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 decision conflict Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 1.9
Comparison 1 personalised risk communication versus general risk information, Outcome 9 decision conflict.

Comparison 1 personalised risk communication versus general risk information, Outcome 9 decision conflict.

9.1 calculated risk score (numerical) v general information

1

Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]

10 satisfaction with decision Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.10
Comparison 1 personalised risk communication versus general risk information, Outcome 10 satisfaction with decision.

Comparison 1 personalised risk communication versus general risk information, Outcome 10 satisfaction with decision.

10.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 intention to take screening test Show forest plot

7

Odds Ratio (Random, 95% CI)

Totals not selected
Analysis 1.11
Comparison 1 personalised risk communication versus general risk information, Outcome 11 intention to take screening test.

Comparison 1 personalised risk communication versus general risk information, Outcome 11 intention to take screening test.

11.1 calculated risk score (numerical) v general information

1

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

11.2 calculated risk score (categorised) v general information

3

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

3

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

12 intention to take genetic screening test in normal risk patients Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.12
Comparison 1 personalised risk communication versus general risk information, Outcome 12 intention to take genetic screening test in normal risk patients.

Comparison 1 personalised risk communication versus general risk information, Outcome 12 intention to take genetic screening test in normal risk patients.

12.1 calculated risk score (numerical)

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 intention to take genetic screening test in normal risk patients Show forest plot

2

Mean Difference (Random, 95% CI)

‐0.77 [‐1.42, ‐0.13]
Analysis 1.13
Comparison 1 personalised risk communication versus general risk information, Outcome 13 intention to take genetic screening test in normal risk patients.

Comparison 1 personalised risk communication versus general risk information, Outcome 13 intention to take genetic screening test in normal risk patients.

13.1 calculated risk score (numerical)

1

Mean Difference (Random, 95% CI)

‐0.52 [‐0.61, ‐0.43]

13.2 calculated risk score (categorised)

1

Mean Difference (Random, 95% CI)

‐1.2 [‐1.88, ‐0.52]

14 uptake of screening test Show forest plot

12

6442

Odds Ratio (Fixed, 95% CI)

1.15 [1.02, 1.29]
Analysis 1.14
Comparison 1 personalised risk communication versus general risk information, Outcome 14 uptake of screening test.

Comparison 1 personalised risk communication versus general risk information, Outcome 14 uptake of screening test.

14.1 calculated risk score (numerical) v general information

6

2569

Odds Ratio (Fixed, 95% CI)

0.95 [0.78, 1.15]

14.2 calculated risk score (categorised) v general information

6

3873

Odds Ratio (Fixed, 95% CI)

1.29 [1.11, 1.51]

15 uptake of screening test Show forest plot

20

Odds Ratio (Random, 95% CI)

Totals not selected
Analysis 1.15
Comparison 1 personalised risk communication versus general risk information, Outcome 15 uptake of screening test.

Comparison 1 personalised risk communication versus general risk information, Outcome 15 uptake of screening test.

15.1 personal risk factor list v general information

20

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

16 appropriate use of cholesterol test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.16
Comparison 1 personalised risk communication versus general risk information, Outcome 16 appropriate use of cholesterol test.

Comparison 1 personalised risk communication versus general risk information, Outcome 16 appropriate use of cholesterol test.

16.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17 improvement in risk comprehension/perception Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.17
Comparison 1 personalised risk communication versus general risk information, Outcome 17 improvement in risk comprehension/perception.

Comparison 1 personalised risk communication versus general risk information, Outcome 17 improvement in risk comprehension/perception.

17.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

18 stages of change Show forest plot

Other data

No numeric data
Analysis 1.18

Study

personal risk factor list v general information

Champion 2007

All interventions were effective (compared to usual care) in moving women forward in mammography stage (versus same or backward). However, the combination of tailored telephone and print interventions versus usual care, had the largest effect. (OR 1.949, 95% CI 1.355 to 2.815)

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Skinner 1994

71% did not change; 14% advanced one stage; 12% 'regressed': no significant differences between tailored message and control.

Comparison 1 personalised risk communication versus general risk information, Outcome 18 stages of change.

18.1 personal risk factor list v general information

Other data

No numeric data

19 making a recommended behaviour change Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.19
Comparison 1 personalised risk communication versus general risk information, Outcome 19 making a recommended behaviour change.

Comparison 1 personalised risk communication versus general risk information, Outcome 19 making a recommended behaviour change.

19.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20 Quality of life (SF‐36) Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 1.20
Comparison 1 personalised risk communication versus general risk information, Outcome 20 Quality of life (SF‐36).

Comparison 1 personalised risk communication versus general risk information, Outcome 20 Quality of life (SF‐36).

20.1 calculated risk score (categorised) v general information

1

Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 2. personalised risk communication versus general risk information for PAP SMEARS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 intention to take screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.1
Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 1 intention to take screening test.

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 1 intention to take screening test.

1.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 uptake of screening test Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.2
Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 2 uptake of screening test.

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 2 uptake of screening test.

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 personal risk factor list v general information

2

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 3. personalised risk communication versus general risk information for MAMMOGRAPHY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.1
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 1 knowledge regarding screening test / condition concerned.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 1 knowledge regarding screening test / condition concerned.

1.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 accuracy of perceived risk Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.2
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 accuracy of perceived risk.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 accuracy of perceived risk.

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.3
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

3.1 calculated risk score (numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 intention to take screening test Show forest plot

2

Odds Ratio (Fixed, 95% CI)

Totals not selected
Analysis 3.4
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 4 intention to take screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 4 intention to take screening test.

4.1 calculated risk score (categorised) v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 personal risk factor list v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

5 uptake of screening test Show forest plot

4

1595

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.68, 1.03]
Analysis 3.5
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 5 uptake of screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 5 uptake of screening test.

5.1 calculated risk score (numerical) v general information

4

1595

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.68, 1.03]

6 uptake of screening test Show forest plot

3

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected
Analysis 3.6
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 6 uptake of screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 6 uptake of screening test.

6.1 calculated risk score (categorised) v general information

3

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 uptake of screening test Show forest plot

8

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected
Analysis 3.7
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 uptake of screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 uptake of screening test.

7.1 personal risk factor list v general information

8

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 stages of change Show forest plot

Other data

No numeric data
Analysis 3.8

Study

personal risk factor list v general information

Skinner 1994

71% did not change; 14% advanced one stage; 12% 'regressed': no significant differences between tailored message and control.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 stages of change.

8.1 personal risk factor list v general information

Other data

No numeric data
Open in table viewer
Comparison 4. personalised risk communication versus general risk information for CHOLESTEROL TESTS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 uptake of screening test Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 4.1
Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 1 uptake of screening test.

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 1 uptake of screening test.

1.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 appropriate use of cholesterol test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 4.2
Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 2 appropriate use of cholesterol test.

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 2 appropriate use of cholesterol test.

2.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 5. personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned Show forest plot

3

1156

Std. Mean Difference (Fixed, 95% CI)

0.59 [0.47, 0.71]
Analysis 5.1
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 1 knowledge regarding screening test / condition concerned.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 1 knowledge regarding screening test / condition concerned.

1.1 calculated risk score (numerical) v general information

1

588

Std. Mean Difference (Fixed, 95% CI)

0.40 [0.23, 0.56]

1.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Fixed, 95% CI)

0.57 [0.32, 0.82]

1.3 personal risk factor list v general information

1

308

Std. Mean Difference (Fixed, 95% CI)

1.02 [0.78, 1.26]

2 perceived risk ‐ perceiving self as appropriate candidate for test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.2
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 2 perceived risk ‐ perceiving self as appropriate candidate for test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 2 perceived risk ‐ perceiving self as appropriate candidate for test.

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 accurately perceived risk Show forest plot

2

460

Odds Ratio (M‐H, Fixed, 95% CI)

2.25 [1.44, 3.53]
Analysis 5.3
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 3 accurately perceived risk.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 3 accurately perceived risk.

3.1 calculated risk score (numerical) v general information

1

200

Odds Ratio (M‐H, Fixed, 95% CI)

1.69 [0.70, 4.06]

3.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

2.50 [1.48, 4.20]

4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

3

662

Mean Difference (IV, Fixed, 95% CI)

0.07 [‐0.14, 0.28]
Analysis 5.4
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

4.1 calculated risk score (numerical) v general information

2

402

Mean Difference (IV, Fixed, 95% CI)

0.16 [‐0.16, 0.48]

4.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

5 intention to take screening test Show forest plot

3

854

Odds Ratio (Fixed, 95% CI)

1.29 [0.97, 1.72]
Analysis 5.5
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 5 intention to take screening test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 5 intention to take screening test.

5.1 calculated risk score (categorised) v general information

1

260

Odds Ratio (Fixed, 95% CI)

0.21 [0.07, 0.64]

5.2 personal risk factor list v general information

2

594

Odds Ratio (Fixed, 95% CI)

1.47 [1.09, 1.97]

6 uptake of screening test Show forest plot

5

2085

Odds Ratio (Fixed, 95% CI)

1.22 [1.00, 1.48]
Analysis 5.6
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 6 uptake of screening test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 6 uptake of screening test.

6.1 calculated risk score (numerical) v general information

3

1156

Odds Ratio (Fixed, 95% CI)

1.05 [0.79, 1.40]

6.2 calculated risk score (categorised) v general information

2

929

Odds Ratio (Fixed, 95% CI)

1.38 [1.06, 1.80]

7 uptake of screening test Show forest plot

7

Odds Ratio (Random, 95% CI)

Totals not selected
Analysis 5.7
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 uptake of screening test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 uptake of screening test.

7.1 personal risk factor list v general information

7

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

8 stages of change Show forest plot

Other data

No numeric data
Analysis 5.8

Study

personal risk factor list v general information

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 stages of change.

8.1 personal risk factor list v general information

Other data

No numeric data
Open in table viewer
Comparison 6. personalised risk communication versus general risk information for COLORECTAL SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

2

2107

Odds Ratio (Fixed, 95% CI)

4.99 [3.98, 6.25]
Analysis 6.1
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 Informed decision.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 Informed decision.

1.1 personal risk factor list v general information

2

2107

Odds Ratio (Fixed, 95% CI)

4.99 [3.98, 6.25]

2 knowledge regarding screening test / condition concerned Show forest plot

3

2378

Odds Ratio (M‐H, Fixed, 95% CI)

6.81 [5.57, 8.34]
Analysis 6.2
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 2 knowledge regarding screening test / condition concerned.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 2 knowledge regarding screening test / condition concerned.

2.1 calculated risk score (numerical) v general information

1

271

Odds Ratio (M‐H, Fixed, 95% CI)

4.26 [1.86, 9.74]

2.2 personal risk factor list v general information

2

2107

Odds Ratio (M‐H, Fixed, 95% CI)

7.04 [5.72, 8.67]

3 knowledge regarding screening test / condition concerned Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.3
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 3 knowledge regarding screening test / condition concerned.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 3 knowledge regarding screening test / condition concerned.

3.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.4
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

4.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 satisfaction with decision Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.5
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 5 satisfaction with decision.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 5 satisfaction with decision.

5.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Decision conflict (proportion with low scores) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 6.6
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 6 Decision conflict (proportion with low scores).

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 6 Decision conflict (proportion with low scores).

6.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 6.7
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 7 intention to take screening test.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 7 intention to take screening test.

7.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 uptake of screening test Show forest plot

10

5567

Odds Ratio (M‐H, Random, 95% CI)

1.06 [0.82, 1.37]
Analysis 6.8
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 8 uptake of screening test.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 8 uptake of screening test.

8.1 calculated risk score (numerical) v general information

1

271

Odds Ratio (M‐H, Random, 95% CI)

0.78 [0.28, 2.17]

8.2 calculated risk score (categorised) v general information

3

1557

Odds Ratio (M‐H, Random, 95% CI)

1.34 [1.01, 1.77]

8.3 personal risk factor list v general information

6

3739

Odds Ratio (M‐H, Random, 95% CI)

0.96 [0.68, 1.35]

9 stages of change Show forest plot

Other data

No numeric data
Analysis 6.9

Study

personal risk factor list v general information

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 9 stages of change.

9.1 personal risk factor list v general information

Other data

No numeric data
Open in table viewer
Comparison 7. personalised risk communication versus general risk information for PROSTATE CANCER SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 uptake of screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 7.1
Comparison 7 personalised risk communication versus general risk information for PROSTATE CANCER SCREENING, Outcome 1 uptake of screening test.

Comparison 7 personalised risk communication versus general risk information for PROSTATE CANCER SCREENING, Outcome 1 uptake of screening test.

1.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Open in table viewer
Comparison 8. Personalised risk communication versus general risk information for SKIN CANCER SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned (Generic Inverse Variance) Show forest plot

1

Std. Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 8.1
Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 1 knowledge regarding screening test / condition concerned (Generic Inverse Variance).

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 1 knowledge regarding screening test / condition concerned (Generic Inverse Variance).

1.1 calculated risk score(numerical) v general information

1

Std. Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]

2 intention to take screening test Show forest plot

1

Odds Ratio (Fixed, 95% CI)

Totals not selected
Analysis 8.2
Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 2 intention to take screening test.

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 2 intention to take screening test.

2.1 Personal risk factor list v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

3 uptake of screening test Show forest plot

3

1284

Odds Ratio (Fixed, 95% CI)

1.69 [1.32, 2.18]
Analysis 8.3
Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 3 uptake of screening test.

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 3 uptake of screening test.

3.1 calculated risk score(numerical) v general information

1

587

Odds Ratio (Fixed, 95% CI)

1.67 [1.04, 2.69]

3.2 personal risk factor list v general information

2

697

Odds Ratio (Fixed, 95% CI)

1.70 [1.26, 2.29]
Open in table viewer
Comparison 9. Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]
Analysis 9.1
Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 1 Informed decision.

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 1 Informed decision.

1.1 calculated risk score(numerical) v general information

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]

2 knowledge regarding screening test / condition concerned Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 9.2
Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 2 knowledge regarding screening test / condition concerned.

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 2 knowledge regarding screening test / condition concerned.

2.1 calculated risk score(numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 uptake of screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 9.3
Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 3 uptake of screening test.

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 3 uptake of screening test.

3.1 calculated risk score(numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.4
Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 4 anxiety.

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 4 anxiety.

4.1 calculated risk score(numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 decision conflict Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.5
Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 5 decision conflict.

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 5 decision conflict.

5.1 calculated risk score(numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Study flow diagram. Search dates from 2006 to March 2012.
Figures and Tables -
Figure 1

Study flow diagram. Search dates from 2006 to March 2012.

Navigate to figure in ReviewOpen in new tab

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Navigate to figure in ReviewOpen in new tab

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 1 Informed decision.
Figures and Tables -
Analysis 1.1

Comparison 1 personalised risk communication versus general risk information, Outcome 1 Informed decision.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 2 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 1.2

Comparison 1 personalised risk communication versus general risk information, Outcome 2 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.
Figures and Tables -
Analysis 1.3

Comparison 1 personalised risk communication versus general risk information, Outcome 3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.
Figures and Tables -
Analysis 1.4

Comparison 1 personalised risk communication versus general risk information, Outcome 4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 5 accurately perceived risk.
Figures and Tables -
Analysis 1.5

Comparison 1 personalised risk communication versus general risk information, Outcome 5 accurately perceived risk.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 6 perceived risk ‐ perceiving self as appropriate candidate for test.
Figures and Tables -
Analysis 1.6

Comparison 1 personalised risk communication versus general risk information, Outcome 6 perceived risk ‐ perceiving self as appropriate candidate for test.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).
Figures and Tables -
Analysis 1.7

Comparison 1 personalised risk communication versus general risk information, Outcome 7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 8 decision conflict (proportion with lower scores).
Figures and Tables -
Analysis 1.8

Comparison 1 personalised risk communication versus general risk information, Outcome 8 decision conflict (proportion with lower scores).

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 9 decision conflict.
Figures and Tables -
Analysis 1.9

Comparison 1 personalised risk communication versus general risk information, Outcome 9 decision conflict.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 10 satisfaction with decision.
Figures and Tables -
Analysis 1.10

Comparison 1 personalised risk communication versus general risk information, Outcome 10 satisfaction with decision.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 11 intention to take screening test.
Figures and Tables -
Analysis 1.11

Comparison 1 personalised risk communication versus general risk information, Outcome 11 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 12 intention to take genetic screening test in normal risk patients.
Figures and Tables -
Analysis 1.12

Comparison 1 personalised risk communication versus general risk information, Outcome 12 intention to take genetic screening test in normal risk patients.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 13 intention to take genetic screening test in normal risk patients.
Figures and Tables -
Analysis 1.13

Comparison 1 personalised risk communication versus general risk information, Outcome 13 intention to take genetic screening test in normal risk patients.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 14 uptake of screening test.
Figures and Tables -
Analysis 1.14

Comparison 1 personalised risk communication versus general risk information, Outcome 14 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 15 uptake of screening test.
Figures and Tables -
Analysis 1.15

Comparison 1 personalised risk communication versus general risk information, Outcome 15 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 16 appropriate use of cholesterol test.
Figures and Tables -
Analysis 1.16

Comparison 1 personalised risk communication versus general risk information, Outcome 16 appropriate use of cholesterol test.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 17 improvement in risk comprehension/perception.
Figures and Tables -
Analysis 1.17

Comparison 1 personalised risk communication versus general risk information, Outcome 17 improvement in risk comprehension/perception.

Navigate to figure in ReviewOpen in new tab

Study

personal risk factor list v general information

Champion 2007

All interventions were effective (compared to usual care) in moving women forward in mammography stage (versus same or backward). However, the combination of tailored telephone and print interventions versus usual care, had the largest effect. (OR 1.949, 95% CI 1.355 to 2.815)

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Skinner 1994

71% did not change; 14% advanced one stage; 12% 'regressed': no significant differences between tailored message and control.

Figures and Tables -
Analysis 1.18

Comparison 1 personalised risk communication versus general risk information, Outcome 18 stages of change.

Navigate to figure in Review

Comparison 1 personalised risk communication versus general risk information, Outcome 19 making a recommended behaviour change.
Figures and Tables -
Analysis 1.19

Comparison 1 personalised risk communication versus general risk information, Outcome 19 making a recommended behaviour change.

Navigate to figure in ReviewOpen in new tab

Comparison 1 personalised risk communication versus general risk information, Outcome 20 Quality of life (SF‐36).
Figures and Tables -
Analysis 1.20

Comparison 1 personalised risk communication versus general risk information, Outcome 20 Quality of life (SF‐36).

Navigate to figure in ReviewOpen in new tab

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 1 intention to take screening test.
Figures and Tables -
Analysis 2.1

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 1 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 2 uptake of screening test.
Figures and Tables -
Analysis 2.2

Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 2 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 1 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 3.1

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 1 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 accuracy of perceived risk.
Figures and Tables -
Analysis 3.2

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 accuracy of perceived risk.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).
Figures and Tables -
Analysis 3.3

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 4 intention to take screening test.
Figures and Tables -
Analysis 3.4

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 4 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 5 uptake of screening test.
Figures and Tables -
Analysis 3.5

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 5 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 6 uptake of screening test.
Figures and Tables -
Analysis 3.6

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 6 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 uptake of screening test.
Figures and Tables -
Analysis 3.7

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Study

personal risk factor list v general information

Skinner 1994

71% did not change; 14% advanced one stage; 12% 'regressed': no significant differences between tailored message and control.

Figures and Tables -
Analysis 3.8

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 stages of change.

Navigate to figure in Review

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 1 uptake of screening test.
Figures and Tables -
Analysis 4.1

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 1 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 2 appropriate use of cholesterol test.
Figures and Tables -
Analysis 4.2

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 2 appropriate use of cholesterol test.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 1 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 5.1

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 1 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 2 perceived risk ‐ perceiving self as appropriate candidate for test.
Figures and Tables -
Analysis 5.2

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 2 perceived risk ‐ perceiving self as appropriate candidate for test.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 3 accurately perceived risk.
Figures and Tables -
Analysis 5.3

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 3 accurately perceived risk.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).
Figures and Tables -
Analysis 5.4

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 5 intention to take screening test.
Figures and Tables -
Analysis 5.5

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 5 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 6 uptake of screening test.
Figures and Tables -
Analysis 5.6

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 6 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 uptake of screening test.
Figures and Tables -
Analysis 5.7

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Study

personal risk factor list v general information

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Figures and Tables -
Analysis 5.8

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 stages of change.

Navigate to figure in Review

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 Informed decision.
Figures and Tables -
Analysis 6.1

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 Informed decision.

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 2 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 6.2

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 2 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 3 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 6.3

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 3 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).
Figures and Tables -
Analysis 6.4

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 5 satisfaction with decision.
Figures and Tables -
Analysis 6.5

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 5 satisfaction with decision.

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 6 Decision conflict (proportion with low scores).
Figures and Tables -
Analysis 6.6

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 6 Decision conflict (proportion with low scores).

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 7 intention to take screening test.
Figures and Tables -
Analysis 6.7

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 7 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 8 uptake of screening test.
Figures and Tables -
Analysis 6.8

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 8 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Study

personal risk factor list v general information

Rawl 2008

Forward movement of stage was:

  • 18% among risk tailored group versus 12% for control group for Faecal Occult Blood Test (FOBT)

  • 36% among risk tailored group versus 24% for control group for colonoscopic screening

Forward movement of stage was slightly higher in the risk tailored group.

Figures and Tables -
Analysis 6.9

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 9 stages of change.

Navigate to figure in Review

Comparison 7 personalised risk communication versus general risk information for PROSTATE CANCER SCREENING, Outcome 1 uptake of screening test.
Figures and Tables -
Analysis 7.1

Comparison 7 personalised risk communication versus general risk information for PROSTATE CANCER SCREENING, Outcome 1 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 1 knowledge regarding screening test / condition concerned (Generic Inverse Variance).
Figures and Tables -
Analysis 8.1

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 1 knowledge regarding screening test / condition concerned (Generic Inverse Variance).

Navigate to figure in ReviewOpen in new tab

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 2 intention to take screening test.
Figures and Tables -
Analysis 8.2

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 2 intention to take screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 3 uptake of screening test.
Figures and Tables -
Analysis 8.3

Comparison 8 Personalised risk communication versus general risk information for SKIN CANCER SCREENING, Outcome 3 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 1 Informed decision.
Figures and Tables -
Analysis 9.1

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 1 Informed decision.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 2 knowledge regarding screening test / condition concerned.
Figures and Tables -
Analysis 9.2

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 2 knowledge regarding screening test / condition concerned.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 3 uptake of screening test.
Figures and Tables -
Analysis 9.3

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 3 uptake of screening test.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 4 anxiety.
Figures and Tables -
Analysis 9.4

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 4 anxiety.

Navigate to figure in ReviewOpen in new tab

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 5 decision conflict.
Figures and Tables -
Analysis 9.5

Comparison 9 Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY, Outcome 5 decision conflict.

Navigate to figure in ReviewOpen in new tab
Summary of findings for the main comparison. Personalised risk communication versus general risk information for informed decision making about taking screening tests

Patient or population: patients with informed decision making about taking screening tests
Settings: screening test in primary and secondary care setting
Intervention: personalised risk communication versus general risk information

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk8

Corresponding risk

Control

Personalised risk communication versus general risk information

Informed decision ‐ Numerical risk and categorised risk combined
MMIC1

202 per 1000

480 per 1000
(350 to 612)

OR 3.65
(2.13 to 6.23)

2444
(3 studies)

⊕⊕⊕⊕
high2,3,4,7

Random‐effects estimate presented due to significant heterogeneity

Uptake of screening test ‐ Numerical and categorised risk combined
Number of participants taking up the test

532 per 1000

566 per 1000
(537 to 594)

OR 1.15
(1.02 to 1.29)

6442
(12 studies)

⊕⊕⊝⊝
low5,6,7

Fixed‐effect estimate

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence (we have not assessed publication bias for any of the groups)
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 MMIC: Multi‐dimensional Measure of Informed Choice
2 Significant heterogeneity among studies but all studies have same direction of effect and hence not down graded.
3Good quality randomised studies with low risk of bias.
4All studies consistently demonstrating an odds ratio of > 2 and quality upgraded by one point.
5Moderate or low heterogeneity among studies and not down graded for inconsistency.
6Out of 12 studies: 5 mentioned generation of random sequence, only 2 studies mentioned concealing allocation, blinding of participants, personnel and outcome assessors was mostly unclear across studies, 9 studies were low risk for attrition bias and 5 studies were high risk for reporting bias. Quality was downgraded by 1 point.
7Personalised risk communication is delivered as a part of the interventions. Informed choice and uptake are promoted by influencing many other elements such as knowledge, perceived risk etc leading to indirectness of evidence and hence down graded by a point.

8Control risk was used as baseline risk, due to lack of studies that measure this in detail to be presented as baseline risk for the population.

Figures and Tables -
Summary of findings for the main comparison. Personalised risk communication versus general risk information for informed decision making about taking screening tests
Navigate to table in Review
Summary of findings 2. Personalised risk communication versus general risk information for informed decision making about taking screening tests

Patient or population: patients with informed decision making about taking screening tests
Settings: screening test in primary and secondary care setting
Intervention: personalised risk communication versus general risk information

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk10

Corresponding risk

Control

Personalised risk communication versus general risk information

Knowledge regarding screening test/condition concerned ‐ calculated risk score (numerical) versus general information
various continuous scales

The mean knowledge regarding screening test/condition concerned ‐ calculated risk score (numerical) versus general information in the intervention group was
0.4 standard deviations higher
(0.23 to 0.56 higher)

588
(1 study)

⊕⊕⊕⊝
moderate1,14

SMD 0.4 (0.23 to 0.56)

Fixed‐effect estimate

Knowledge regarding screening test/condition concerned ‐ calculated risk score (categorised) versus general information
various continuous scales

The mean knowledge regarding screening test/condition concerned ‐ calculated risk score (categorised) versus general information in the intervention group was
0.57 standard deviations higher
(0.32 to 0.82 higher)

260
(1 study)

⊕⊕⊝⊝
low2,11,14

SMD 0.57 (0.32 to 0.82)

Fixed‐effect estimate

Knowledge regarding screening test/condition concerned ‐ personal risk factor list versus general information
various continuous scales

The mean knowledge regarding screening test/condition concerned ‐ personal risk factor list versus general information in the intervention group was
0.89 standard deviations higher
(0.75 to 1.04 higher)

838
(2 studies)

⊕⊕⊕⊕
high3,14

SMD 0.89 (0.75 to 1.04)

Fixed effect estimate

Knowledge regarding screening test/condition concerned ‐ calculated risk score (numerical) versus general information
proportion with good knowledge

244 per 1000

457 per 1000
(291 to 633)

OR 2.6
(1.27 to 5.34)

1413
(3 studies)

⊕⊕⊕⊕

high4,6,13,14

Random‐effects estimate

Knowledge regarding screening test / condition concerned ‐ personal risk factor list v general information
proportion with good knowledge

166 per 1000

586 per 1000
(535 to 636)

OR 7.13
(5.79 to 8.79)

2107
(2 studies)

⊕⊕⊕⊕
high6, 12,14

Fixed‐effect estimate

Accurately‐perceived risk
proportion of participants who perceived risk accurately

225 per 1000

324 per 1000
(218 to 450)

OR 1.65
(0.96 to 2.81)

1264
(3 studies)

⊕⊕⊝⊝
low7,8,13,14

Random‐effects estimate

Anxiety ‐ all groups
various continuous scales

The mean anxiety in the intervention groups was
0.13 standard deviations lower
(0.29 lower to 0.03 higher)

1848
(6 studies)

⊕⊝⊝⊝
very low5,8,9,14

SMD ‐0.13 (‐0.29 to 0.03)

Random‐effects estimate

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence (we have not assessed publication bias for any of the groups)
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 This study was high risk for reporting bias. Four risk of bias items were low risk and four were unclear risk. Quality down graded by a point.
2 Seven out of nine risk of bias items were unclear. Quality down graded by a point.
3 One out of two studies included in this analysis was of very good quality. The other study had mostly unclear risk of bias. Overall we have not downgraded the quality for this analysis.
4 Two out of three studies had more than four risk of bias items assessed as low risk. The other study had most unclear risk of bias items. Overall quality was not downgraded.
5 Substantial/significant heterogeneity of results exists and all studies did not show similar direction of effect. Quality down graded by a point.
6 Consistently large effects favouring personalised risk communication and hence upgraded the quality by one point.
7 Most risk of bias items were unclear with some high risk items. Quality downgraded by one point.
8 Pooled estimate includes no effect and hence down graded by one point.
9 Two out of six studies had more than four risk of bias items assessed as low risk. The remaining studies had most risk of bias items assessed as unclear. Quality downgraded by one point.

10Control risk was used as baseline risk due to lack of studies that measure this in detail to be presented as baseline risk for the population.

11Sample size less than the Optimal Information size (OIS). Quality downgraded by one point.

12Both studies were of low risk of bias and hence not downgraded.

13Significant heterogeneity among studies but all studies have same direction of effect and hence quality not down graded.

14Not downgraded for indirectness of evidence.

Figures and Tables -
Summary of findings 2. Personalised risk communication versus general risk information for informed decision making about taking screening tests
Navigate to table in Review
Comparison 1. personalised risk communication versus general risk information

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

3

2444

Odds Ratio (Fixed, 95% CI)

4.48 [3.62, 5.53]

1.1 calculated risk score (numerical) v general information

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]

1.2 personal risk factor list v general information

2

2106

Odds Ratio (Fixed, 95% CI)

4.98 [3.97, 6.24]

2 knowledge regarding screening test / condition concerned Show forest plot

4

Std. Mean Difference (Fixed, 95% CI)

Subtotals only

2.1 calculated risk score (numerical) v general information

1

588

Std. Mean Difference (Fixed, 95% CI)

0.40 [0.23, 0.56]

2.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Fixed, 95% CI)

0.57 [0.32, 0.82]

2.3 personal risk factor list v general information

2

838

Std. Mean Difference (Fixed, 95% CI)

0.89 [0.75, 1.04]

3 knowledge regarding screening test / condition concerned‐ proportion with good knowledge Show forest plot

3

Odds Ratio (Random, 95% CI)

Subtotals only

3.1 calculated risk score (numerical) v general information

3

1413

Odds Ratio (Random, 95% CI)

2.60 [1.27, 5.34]

4 knowledge regarding screening test / condition concerned‐ proportion with good knowledge Show forest plot

2

2107

Odds Ratio (Fixed, 95% CI)

7.13 [5.79, 8.79]

4.1 personal risk factor list v general information

2

2107

Odds Ratio (Fixed, 95% CI)

7.13 [5.79, 8.79]

5 accurately perceived risk Show forest plot

3

1264

Odds Ratio (M‐H, Random, 95% CI)

1.65 [0.96, 2.81]

5.1 calculated risk score (numerical) v general information

2

1004

Odds Ratio (M‐H, Random, 95% CI)

1.22 [0.91, 1.64]

5.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Random, 95% CI)

2.50 [1.48, 4.20]

6 perceived risk ‐ perceiving self as appropriate candidate for test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

6

1848

Std. Mean Difference (Random, 95% CI)

‐0.13 [‐0.29, 0.03]

7.1 calculated risk score (numerical) v general information

4

1058

Std. Mean Difference (Random, 95% CI)

‐0.19 [‐0.42, 0.04]

7.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Random, 95% CI)

0.0 [‐0.24, 0.24]

7.3 personal risk factor list v general information

1

530

Std. Mean Difference (Random, 95% CI)

‐0.02 [‐0.20, 0.16]

8 decision conflict (proportion with lower scores) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

8.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 decision conflict Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected

9.1 calculated risk score (numerical) v general information

1

Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]

10 satisfaction with decision Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

10.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 intention to take screening test Show forest plot

7

Odds Ratio (Random, 95% CI)

Totals not selected

11.1 calculated risk score (numerical) v general information

1

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

11.2 calculated risk score (categorised) v general information

3

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

3

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

12 intention to take genetic screening test in normal risk patients Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

12.1 calculated risk score (numerical)

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 intention to take genetic screening test in normal risk patients Show forest plot

2

Mean Difference (Random, 95% CI)

‐0.77 [‐1.42, ‐0.13]

13.1 calculated risk score (numerical)

1

Mean Difference (Random, 95% CI)

‐0.52 [‐0.61, ‐0.43]

13.2 calculated risk score (categorised)

1

Mean Difference (Random, 95% CI)

‐1.2 [‐1.88, ‐0.52]

14 uptake of screening test Show forest plot

12

6442

Odds Ratio (Fixed, 95% CI)

1.15 [1.02, 1.29]

14.1 calculated risk score (numerical) v general information

6

2569

Odds Ratio (Fixed, 95% CI)

0.95 [0.78, 1.15]

14.2 calculated risk score (categorised) v general information

6

3873

Odds Ratio (Fixed, 95% CI)

1.29 [1.11, 1.51]

15 uptake of screening test Show forest plot

20

Odds Ratio (Random, 95% CI)

Totals not selected

15.1 personal risk factor list v general information

20

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

16 appropriate use of cholesterol test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

16.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17 improvement in risk comprehension/perception Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

17.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

18 stages of change Show forest plot

Other data

No numeric data

18.1 personal risk factor list v general information

Other data

No numeric data

19 making a recommended behaviour change Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

19.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20 Quality of life (SF‐36) Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected

20.1 calculated risk score (categorised) v general information

1

Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 1. personalised risk communication versus general risk information
Navigate to table in Review
Comparison 2. personalised risk communication versus general risk information for PAP SMEARS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 intention to take screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 uptake of screening test Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 personal risk factor list v general information

2

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 2. personalised risk communication versus general risk information for PAP SMEARS
Navigate to table in Review
Comparison 3. personalised risk communication versus general risk information for MAMMOGRAPHY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 accuracy of perceived risk Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 calculated risk score (numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 intention to take screening test Show forest plot

2

Odds Ratio (Fixed, 95% CI)

Totals not selected

4.1 calculated risk score (categorised) v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 personal risk factor list v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

5 uptake of screening test Show forest plot

4

1595

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.68, 1.03]

5.1 calculated risk score (numerical) v general information

4

1595

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.68, 1.03]

6 uptake of screening test Show forest plot

3

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

6.1 calculated risk score (categorised) v general information

3

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 uptake of screening test Show forest plot

8

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

7.1 personal risk factor list v general information

8

Odds Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

8 stages of change Show forest plot

Other data

No numeric data

8.1 personal risk factor list v general information

Other data

No numeric data
Figures and Tables -
Comparison 3. personalised risk communication versus general risk information for MAMMOGRAPHY
Navigate to table in Review
Comparison 4. personalised risk communication versus general risk information for CHOLESTEROL TESTS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 uptake of screening test Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 appropriate use of cholesterol test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 4. personalised risk communication versus general risk information for CHOLESTEROL TESTS
Navigate to table in Review
Comparison 5. personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned Show forest plot

3

1156

Std. Mean Difference (Fixed, 95% CI)

0.59 [0.47, 0.71]

1.1 calculated risk score (numerical) v general information

1

588

Std. Mean Difference (Fixed, 95% CI)

0.40 [0.23, 0.56]

1.2 calculated risk score (categorised) v general information

1

260

Std. Mean Difference (Fixed, 95% CI)

0.57 [0.32, 0.82]

1.3 personal risk factor list v general information

1

308

Std. Mean Difference (Fixed, 95% CI)

1.02 [0.78, 1.26]

2 perceived risk ‐ perceiving self as appropriate candidate for test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 accurately perceived risk Show forest plot

2

460

Odds Ratio (M‐H, Fixed, 95% CI)

2.25 [1.44, 3.53]

3.1 calculated risk score (numerical) v general information

1

200

Odds Ratio (M‐H, Fixed, 95% CI)

1.69 [0.70, 4.06]

3.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

2.50 [1.48, 4.20]

4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

3

662

Mean Difference (IV, Fixed, 95% CI)

0.07 [‐0.14, 0.28]

4.1 calculated risk score (numerical) v general information

2

402

Mean Difference (IV, Fixed, 95% CI)

0.16 [‐0.16, 0.48]

4.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

5 intention to take screening test Show forest plot

3

854

Odds Ratio (Fixed, 95% CI)

1.29 [0.97, 1.72]

5.1 calculated risk score (categorised) v general information

1

260

Odds Ratio (Fixed, 95% CI)

0.21 [0.07, 0.64]

5.2 personal risk factor list v general information

2

594

Odds Ratio (Fixed, 95% CI)

1.47 [1.09, 1.97]

6 uptake of screening test Show forest plot

5

2085

Odds Ratio (Fixed, 95% CI)

1.22 [1.00, 1.48]

6.1 calculated risk score (numerical) v general information

3

1156

Odds Ratio (Fixed, 95% CI)

1.05 [0.79, 1.40]

6.2 calculated risk score (categorised) v general information

2

929

Odds Ratio (Fixed, 95% CI)

1.38 [1.06, 1.80]

7 uptake of screening test Show forest plot

7

Odds Ratio (Random, 95% CI)

Totals not selected

7.1 personal risk factor list v general information

7

Odds Ratio (Random, 95% CI)

0.0 [0.0, 0.0]

8 stages of change Show forest plot

Other data

No numeric data

8.1 personal risk factor list v general information

Other data

No numeric data
Figures and Tables -
Comparison 5. personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE
Navigate to table in Review
Comparison 6. personalised risk communication versus general risk information for COLORECTAL SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

2

2107

Odds Ratio (Fixed, 95% CI)

4.99 [3.98, 6.25]

1.1 personal risk factor list v general information

2

2107

Odds Ratio (Fixed, 95% CI)

4.99 [3.98, 6.25]

2 knowledge regarding screening test / condition concerned Show forest plot

3

2378

Odds Ratio (M‐H, Fixed, 95% CI)

6.81 [5.57, 8.34]

2.1 calculated risk score (numerical) v general information

1

271

Odds Ratio (M‐H, Fixed, 95% CI)

4.26 [1.86, 9.74]

2.2 personal risk factor list v general information

2

2107

Odds Ratio (M‐H, Fixed, 95% CI)

7.04 [5.72, 8.67]

3 knowledge regarding screening test / condition concerned Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 satisfaction with decision Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 personal risk factor list v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Decision conflict (proportion with low scores) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7.1 calculated risk score (numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 uptake of screening test Show forest plot

10

5567

Odds Ratio (M‐H, Random, 95% CI)

1.06 [0.82, 1.37]

8.1 calculated risk score (numerical) v general information

1

271

Odds Ratio (M‐H, Random, 95% CI)

0.78 [0.28, 2.17]

8.2 calculated risk score (categorised) v general information

3

1557

Odds Ratio (M‐H, Random, 95% CI)

1.34 [1.01, 1.77]

8.3 personal risk factor list v general information

6

3739

Odds Ratio (M‐H, Random, 95% CI)

0.96 [0.68, 1.35]

9 stages of change Show forest plot

Other data

No numeric data

9.1 personal risk factor list v general information

Other data

No numeric data
Figures and Tables -
Comparison 6. personalised risk communication versus general risk information for COLORECTAL SCREENING
Navigate to table in Review
Comparison 7. personalised risk communication versus general risk information for PROSTATE CANCER SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 uptake of screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 personal risk factor list v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 7. personalised risk communication versus general risk information for PROSTATE CANCER SCREENING
Navigate to table in Review
Comparison 8. Personalised risk communication versus general risk information for SKIN CANCER SCREENING

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned (Generic Inverse Variance) Show forest plot

1

Std. Mean Difference (Fixed, 95% CI)

Totals not selected

1.1 calculated risk score(numerical) v general information

1

Std. Mean Difference (Fixed, 95% CI)

0.0 [0.0, 0.0]

2 intention to take screening test Show forest plot

1

Odds Ratio (Fixed, 95% CI)

Totals not selected

2.1 Personal risk factor list v general information

1

Odds Ratio (Fixed, 95% CI)

0.0 [0.0, 0.0]

3 uptake of screening test Show forest plot

3

1284

Odds Ratio (Fixed, 95% CI)

1.69 [1.32, 2.18]

3.1 calculated risk score(numerical) v general information

1

587

Odds Ratio (Fixed, 95% CI)

1.67 [1.04, 2.69]

3.2 personal risk factor list v general information

2

697

Odds Ratio (Fixed, 95% CI)

1.70 [1.26, 2.29]
Figures and Tables -
Comparison 8. Personalised risk communication versus general risk information for SKIN CANCER SCREENING
Navigate to table in Review
Comparison 9. Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Informed decision Show forest plot

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]

1.1 calculated risk score(numerical) v general information

1

338

Odds Ratio (Fixed, 95% CI)

2.08 [1.14, 3.81]

2 knowledge regarding screening test / condition concerned Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 calculated risk score(numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 uptake of screening test Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3.1 calculated risk score(numerical) v general information

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 calculated risk score(numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 decision conflict Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 calculated risk score(numerical) v general information

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figures and Tables -
Comparison 9. Personalised risk communication versus general risk information for PRENATAL TESTING FOR FOETAL ABNORMALITY
Navigate to table in Review