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Personalised risk communication for informed decision making about taking screening tests

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Referencias

References to studies included in this review

Ir a:

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.

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.

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Champion 2002 {published data only (unpublished sought but not used)}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, Skinner CS. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Preventive Medicine 2003;36(2):150‐8.

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.

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 & 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 worksite 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, Balshem A. 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, Reed MM. 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, Ransohoff D. 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.

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.

Rimer 2002 {published data only}

Rimer B, Halabi S, Skinner C, Lipkus I, Strigo T, Kaplan E, Samsa G. 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 & 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.

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.

References to studies excluded from this review

Ir a:

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.

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.

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.

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.

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 & 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, Barber T. The impact of tailored interventions on a community health center population. Patient Education & Counseling 1999;37(2):125‐40.

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.

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.

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.

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.

Covello 1986

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

Edwards 1999

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 2000a

Edwards A, Hood K, Matthews E, Barker J, Bloor M, Burnard P, et al. The effectiveness of one‐to‐one risk communication interventions in health care: a systematic review. Medical Decision Making 2000;20(3):290‐7.

Edwards 2000b

Edwards AGK, Elwyn GJ, Hood K, Rollnick S. Judging the 'weight of evidence' in systematic reviews: introducing rigour into the qualitative overview stage by assessing signal and noise. Journal of Evaluation in Clinical Practice 2000;6(2):177‐84.

Edwards 2001

Edwards A, Elwyn G, Covey J, Mathews E, Pill R. Presenting risk information ‐ a review of the effects of 'framing' and other manipulations on patient outcomes. Journal of Health Communication 2001;6(1):61‐82.

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 & 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.

Fischhoff 1979

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

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.

Guadagnoli 1998

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

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.

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?. First 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.

Irwig 2006

Irwig L, McCaffery K, Salkeld G, Bossuyt P. Screening and choice: informed choice for screening: implications for evaluation. BMJ 2006;332:1148‐1150.

Jadad 1996

Jadad A, Moore M, Carrol D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomised clinical trials; is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12.

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.

Keeney 1986

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

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 ischemic heart disease. Journal of General Internal Medicine 1996;11(6):373‐6.

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 1992

Marteau TM, Bekker H. The development of a six‐item short form of the state scale of the Spielberger state‐trait anxiety inventory. British Journal of Clinical Psychology 1992;31(Pt 3):301‐6.

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.

O'Connor 1995

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

O'Connor 2003

O'Connor AM, Stacey D, Entwistle V, Llewellyn‐Thomas H, Rovner D, Holmes‐Rovner M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD001431]

Oncology 1994

Oncology (Anonymous). Genetic testing for cancer risk: research projects being funded. Oncology 1994;8(12):16‐8.

Prochaska 1992

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

Raffle 2001

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

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. British Medical Journal 1978;2(6149):1417‐8.

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.

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.

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.

Wilson 1968

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

References to other published versions of this review

Ir a:

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]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Bastani 1999

Methods

RCT

Participants

Women over 30; breast cancer in first degree relative; resident in USA or Canada.

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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Bowen 2002

Methods

RCT

Participants

Women with first degree relative with breast cancer; Seattle, USA.

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.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Campbell 1997

Methods

RCT

Participants

Women who had not had a cervical (Pap) smear in previous 30 months; New South Wales, Australia.

Interventions

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

Outcomes

Uptake of cervical (Pap) smear.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Champion 1994

Methods

RCT

Participants

Women aged >= 35 ; never having had breast cancer. USA.

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 1 year post‐intervention.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
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).

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.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Champion 2000a

Methods

RCT

Participants

Low‐income African American women aged 45‐64; Indiana, USA.

Interventions

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

Outcomes

Screening mammography uptake at 12 months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Champion 2002

Methods

RCT

Participants

Women aged over 50 not adherent to mammography recommendations; medical clinic at St Louis and HMO in Indianapolis, USA.

Interventions

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

Outcomes

Self‐reported mammography uptake at 2 months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Champion 2003

Methods

RCT

Participants

Women in the 51‐84 years age range who have not received a mammogram in the last 15 months; from an HMO and general medicine clinic, USA.

Interventions

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

Outcomes

Screening mammography uptake at 6 months.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Low risk

A ‐ Adequate
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,

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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Hutchison 1998

Methods

RCT

Participants

Patients aged 20‐69 years, from 2 Canadian primary care group practices.

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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Jibaja‐Weiss 2003

Methods

RCT

Participants

Women registered at 2 urban community health centres; Houston, USA.

Interventions

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

Outcomes

Scheduling and uptake of cervical (Pap) smear test and mammogram.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Low risk

A ‐ Adequate
Kreuter 1996

Methods

RCT

Participants

Patients aged 18‐75 from 8 family medical practices, N. Carolina, USA.

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 6 months in those contemplating these behaviours at baseline.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

High risk

C ‐ Inadequate
Lee 1991

Methods

RCT, stratified for previous screening history and risk status.

Participants

Federal employees aged >= 40 years. USA.

Interventions

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

Outcomes

Knowledge, intention to take test, and uptake.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Lerman 1995

Methods

RCT

Participants

Women aged 35 years and older with a family history of breast cancer in a first degree relative. USA.

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 et al, 1996) addresses effects on general and breast cancer‐specific distress.

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Lerman 1997

Methods

RCT

Participants

Women aged 18‐75 who had at least one first degree relative with breast and/or ovarian cancer. USA.

Interventions

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

Outcomes

Changes in risk perception; testing intentions.

Notes

No data on taking test in control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
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.

Interventions

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

Outcomes

Faecal Occult Blood test uptake at 1, 2 and 3 years.

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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Myers 1999

Methods

RCT

Participants

African American men, aged 40‐70 years. Patients at the University of Chicago, USA.

Interventions

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

Outcomes

'Adherence', ie. 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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Rimer 2002

Methods

RCT

Participants

Women in their 40s and 50s , and members of Blue Cross and Blue Shield, N. Carolina, USA.

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.

Notes

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

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Saywell 1999

Methods

RCT

Participants

Women 50‐85 years; non‐compliant with mammography guidelines; no history of breast cancer. USA,

Interventions

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

Outcomes

Mammography compliance 4‐6 weeks after counselling.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Schwartz 1999

Methods

RCT

Participants

Women with family history of breast cancer (first degree relative of sufferer) aged 40 years and older. USA.

Interventions

Risk counselling including individualised risk figures.

Outcomes

Self reported mammography use 1 year after (compared to baseline).

Notes

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

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Skinner 1994

Methods

RCT, stratified between clinics.

Participants

Female family practice attenders aged 40‐65 years. USA.

Interventions

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

Outcomes

Mammography stage and uptake.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear
Skinner 2002

Methods

RCT

Participants

Women with personal and family history of breast and/or ovarian cancer; N. Carolina, USA.

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

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear

RCT = randomised controlled trial.

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Alexander 1996

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

Champion 2000b

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

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.

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.

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.

Weber 1997

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

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 knowledge regarding screening test / condition concerned Show forest plot

2

568

Mean Difference (IV, Fixed, 95% CI)

2.45 [1.94, 2.96]
Analysis 1.1
Comparison 1 personalised risk communication versus general risk information, Outcome 1 knowledge regarding screening test / condition concerned.

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

1.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

12.0 [6.89, 17.11]

1.3 personal risk factor list v general information

1

308

Mean Difference (IV, Fixed, 95% CI)

2.35 [1.84, 2.86]

2 knowledge regarding screening test / condition concerned Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]
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

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

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

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]
Analysis 1.3
Comparison 1 personalised risk communication versus general risk information, Outcome 3 perceived risk ‐ perceiving self as appropriate candidate for test.

Comparison 1 personalised risk communication versus general risk information, Outcome 3 perceived risk ‐ perceiving self as appropriate candidate for test.

3.1 calculated risk score (numerical) v general information

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

3.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 accurately perceived risk Show forest plot

3

1264

Odds Ratio (M‐H, Fixed, 95% CI)

1.46 [1.13, 1.88]
Analysis 1.4
Comparison 1 personalised risk communication versus general risk information, Outcome 4 accurately perceived risk.

Comparison 1 personalised risk communication versus general risk information, Outcome 4 accurately perceived risk.

4.1 calculated risk score (numerical) v general information

2

1004

Odds Ratio (M‐H, Fixed, 95% CI)

1.22 [0.91, 1.64]

4.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

2.50 [1.48, 4.20]

4.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

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

2

499

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.30, 0.25]
Analysis 1.5
Comparison 1 personalised risk communication versus general risk information, Outcome 5 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

Comparison 1 personalised risk communication versus general risk information, Outcome 5 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

5.1 calculated risk score (numerical) v general information

1

239

Mean Difference (IV, Fixed, 95% CI)

‐4.1 [‐7.54, ‐0.66]

5.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 intention to take screening test Show forest plot

5

2016

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.71, 1.03]
Analysis 1.8
Comparison 1 personalised risk communication versus general risk information, Outcome 8 intention to take screening test.

Comparison 1 personalised risk communication versus general risk information, Outcome 8 intention to take screening test.

8.1 calculated risk score (numerical) v general information

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

1.10 [0.63, 1.94]

8.2 calculated risk score (categorised) v general information

2

538

Odds Ratio (M‐H, Fixed, 95% CI)

1.68 [1.12, 2.53]

8.3 personal risk factor list v general information

2

1264

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.54, 0.84]

9 uptake of screening test Show forest plot

14

7341

Odds Ratio (M‐H, Fixed, 95% CI)

1.13 [1.02, 1.24]
Analysis 1.9
Comparison 1 personalised risk communication versus general risk information, Outcome 9 uptake of screening test.

Comparison 1 personalised risk communication versus general risk information, Outcome 9 uptake of screening test.

9.1 calculated risk score (numerical) v general information

2

1234

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.65, 1.03]

9.2 calculated risk score (categorised) v general information

2

1031

Odds Ratio (M‐H, Fixed, 95% CI)

1.42 [1.07, 1.89]

9.3 personal risk factor list v general information

10

5076

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [1.04, 1.32]

10 appropriate use of cholesterol test Show forest plot

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]
Analysis 1.10
Comparison 1 personalised risk communication versus general risk information, Outcome 10 appropriate use of cholesterol test.

Comparison 1 personalised risk communication versus general risk information, Outcome 10 appropriate use of cholesterol test.

10.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]

11 smoking Show forest plot

1

204

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.60, 1.82]
Analysis 1.11
Comparison 1 personalised risk communication versus general risk information, Outcome 11 smoking.

Comparison 1 personalised risk communication versus general risk information, Outcome 11 smoking.

11.1 calculated risk score (numerical) v general information

1

204

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.60, 1.82]

11.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 stages of change Show forest plot

Other data

No numeric data
Analysis 1.12

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 1 personalised risk communication versus general risk information, Outcome 12 stages of change.

12.1 personal risk factor list v general information

Other data

No numeric data

13 improvement in risk comprehension/perception Show forest plot

1

200

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.64 [0.83, 3.25]
Analysis 1.13
Comparison 1 personalised risk communication versus general risk information, Outcome 13 improvement in risk comprehension/perception.

Comparison 1 personalised risk communication versus general risk information, Outcome 13 improvement in risk comprehension/perception.

13.1 calculated risk score (numerical) v general information

1

200

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.64 [0.83, 3.25]

13.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

13.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

14 making a recommended behaviour change Show forest plot

1

890

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.76, 1.28]
Analysis 1.14
Comparison 1 personalised risk communication versus general risk information, Outcome 14 making a recommended behaviour change.

Comparison 1 personalised risk communication versus general risk information, Outcome 14 making a recommended behaviour change.

14.1 personal risk factor list v general information

1

890

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.76, 1.28]

14.2 calculated risk score(categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

14.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, 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

984

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.45, 0.74]
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 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

984

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.45, 0.74]

2 uptake of screening test Show forest plot

3

1552

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.50, 0.77]
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

296

Odds Ratio (M‐H, Fixed, 95% CI)

1.26 [0.75, 2.13]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

2

1256

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.42, 0.67]
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

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 knowledge regarding screening test / condition concerned Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]
Analysis 3.2
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 knowledge regarding screening test / condition concerned.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 knowledge regarding screening test / condition concerned.

2.1 calculated risk score (numerical) v general information

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 accuracy of perceived risk Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.86, 1.60]
Analysis 3.3
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 accuracy of perceived risk.

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

3.1 calculated risk score (numerical) v general information

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.86, 1.60]

3.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 anxiety

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

1

478

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.36, 0.76]
Analysis 3.7
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 intention to take screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 intention to take screening test.

7.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 personal risk factor list v general information

1

478

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.36, 0.76]

8 uptake of screening test Show forest plot

11

5234

Odds Ratio (M‐H, Fixed, 95% CI)

1.11 [0.98, 1.24]
Analysis 3.8
Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 uptake of screening test.

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 uptake of screening test.

8.1 calculated risk score (numerical) v general information

3

1456

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.66, 1.02]

8.2 calculated risk score (categorised) v general information

1

753

Odds Ratio (M‐H, Fixed, 95% CI)

1.37 [1.02, 1.84]

8.3 personal risk factor list v general information

7

3025

Odds Ratio (M‐H, Fixed, 95% CI)

1.22 [1.04, 1.43]

9 stages of change Show forest plot

Other data

No numeric data
Analysis 3.9

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 9 stages of change.

9.1 personal risk factor list v general information

Other data

No numeric data

10 anxiety (Cancer related anxiety and helplessness scale)

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 improvement in risk comprehension/perception

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.1 calculated risk score (numerical) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]
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

1

276

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.57, 1.65]
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

276

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.57, 1.65]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 appropriate use of cholesterol test Show forest plot

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]
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 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]
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

2

568

Mean Difference (IV, Fixed, 95% CI)

2.45 [1.94, 2.96]
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

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

12.0 [6.89, 17.11]

1.3 personal risk factor list v general information

1

308

Mean Difference (IV, Fixed, 95% CI)

2.35 [1.84, 2.86]

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

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]
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

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

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]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety Show forest plot

2

499

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.30, 0.25]
Analysis 5.4
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety.

4.1 calculated risk score (numerical) v general information

1

239

Mean Difference (IV, Fixed, 95% CI)

‐4.1 [‐7.54, ‐0.66]

4.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

4.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

2

540

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.55, 1.27]
Analysis 5.7
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 intention to take screening test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 intention to take screening test.

7.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

0.21 [0.07, 0.65]

7.3 personal risk factor list v general information

1

280

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.72, 1.89]

8 uptake of screening test Show forest plot

5

3145

Odds Ratio (M‐H, Fixed, 95% CI)

1.45 [1.23, 1.71]
Analysis 5.8
Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 uptake of screening test.

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 uptake of screening test.

8.1 calculated risk score (numerical) v general information

2

1355

Odds Ratio (M‐H, Fixed, 95% CI)

1.48 [1.06, 2.07]

8.2 calculated risk score (categorised) v general information

1

753

Odds Ratio (M‐H, Fixed, 95% CI)

1.37 [1.02, 1.84]

8.3 personal risk factor list v general information

2

1037

Odds Ratio (M‐H, Fixed, 95% CI)

1.49 [1.16, 1.91]

9 improvement in risk comprehension/perception

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.1 calculated risk score (numerical) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 anxiety (Cancer related anxiety and helplessness scale)

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
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 uptake of screening test Show forest plot

1

278

Odds Ratio (M‐H, Fixed, 95% CI)

2.09 [0.76, 5.75]
Analysis 6.1
Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 uptake of screening test.

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 uptake of screening test.

1.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

278

Odds Ratio (M‐H, Fixed, 95% CI)

2.09 [0.76, 5.75]

1.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
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

413

Odds Ratio (M‐H, Fixed, 95% CI)

2.56 [1.70, 3.84]
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 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

413

Odds Ratio (M‐H, Fixed, 95% CI)

2.56 [1.70, 3.84]

Comparison 1 personalised risk communication versus general risk information, Outcome 1 knowledge regarding screening test / condition concerned.
Figuras y tablas -
Analysis 1.1

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

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Comparison 1 personalised risk communication versus general risk information, Outcome 2 knowledge regarding screening test / condition concerned.
Figuras y tablas -
Analysis 1.2

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

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Comparison 1 personalised risk communication versus general risk information, Outcome 3 perceived risk ‐ perceiving self as appropriate candidate for test.
Figuras y tablas -
Analysis 1.3

Comparison 1 personalised risk communication versus general risk information, Outcome 3 perceived risk ‐ perceiving self as appropriate candidate for test.

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Comparison 1 personalised risk communication versus general risk information, Outcome 4 accurately perceived risk.
Figuras y tablas -
Analysis 1.4

Comparison 1 personalised risk communication versus general risk information, Outcome 4 accurately perceived risk.

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Comparison 1 personalised risk communication versus general risk information, Outcome 5 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).
Figuras y tablas -
Analysis 1.5

Comparison 1 personalised risk communication versus general risk information, Outcome 5 anxiety (Cancer related anxiety and helplessness scale; IES breast cancer distress).

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Comparison 1 personalised risk communication versus general risk information, Outcome 8 intention to take screening test.
Figuras y tablas -
Analysis 1.8

Comparison 1 personalised risk communication versus general risk information, Outcome 8 intention to take screening test.

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Comparison 1 personalised risk communication versus general risk information, Outcome 9 uptake of screening test.
Figuras y tablas -
Analysis 1.9

Comparison 1 personalised risk communication versus general risk information, Outcome 9 uptake of screening test.

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Comparison 1 personalised risk communication versus general risk information, Outcome 10 appropriate use of cholesterol test.
Figuras y tablas -
Analysis 1.10

Comparison 1 personalised risk communication versus general risk information, Outcome 10 appropriate use of cholesterol test.

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Comparison 1 personalised risk communication versus general risk information, Outcome 11 smoking.
Figuras y tablas -
Analysis 1.11

Comparison 1 personalised risk communication versus general risk information, Outcome 11 smoking.

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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.

Figuras y tablas -
Analysis 1.12

Comparison 1 personalised risk communication versus general risk information, Outcome 12 stages of change.

Ir a la figura de la revisión

Comparison 1 personalised risk communication versus general risk information, Outcome 13 improvement in risk comprehension/perception.
Figuras y tablas -
Analysis 1.13

Comparison 1 personalised risk communication versus general risk information, Outcome 13 improvement in risk comprehension/perception.

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Comparison 1 personalised risk communication versus general risk information, Outcome 14 making a recommended behaviour change.
Figuras y tablas -
Analysis 1.14

Comparison 1 personalised risk communication versus general risk information, Outcome 14 making a recommended behaviour change.

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Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 1 intention to take screening test.
Figuras y tablas -
Analysis 2.1

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

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Comparison 2 personalised risk communication versus general risk information for PAP SMEARS, Outcome 2 uptake of screening test.
Figuras y tablas -
Analysis 2.2

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

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Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 knowledge regarding screening test / condition concerned.
Figuras y tablas -
Analysis 3.2

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 2 knowledge regarding screening test / condition concerned.

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Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 3 accuracy of perceived risk.
Figuras y tablas -
Analysis 3.3

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

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Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 intention to take screening test.
Figuras y tablas -
Analysis 3.7

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 7 intention to take screening test.

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Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 uptake of screening test.
Figuras y tablas -
Analysis 3.8

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 8 uptake of screening test.

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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.

Figuras y tablas -
Analysis 3.9

Comparison 3 personalised risk communication versus general risk information for MAMMOGRAPHY, Outcome 9 stages of change.

Ir a la figura de la revisión

Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 1 uptake of screening test.
Figuras y tablas -
Analysis 4.1

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

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Comparison 4 personalised risk communication versus general risk information for CHOLESTEROL TESTS, Outcome 2 appropriate use of cholesterol test.
Figuras y tablas -
Analysis 4.2

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

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 3 accurately perceived risk.
Figuras y tablas -
Analysis 5.3

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

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Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety.
Figuras y tablas -
Analysis 5.4

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 4 anxiety.

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Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 intention to take screening test.
Figuras y tablas -
Analysis 5.7

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 7 intention to take screening test.

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Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 uptake of screening test.
Figuras y tablas -
Analysis 5.8

Comparison 5 personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE, Outcome 8 uptake of screening test.

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Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 uptake of screening test.
Figuras y tablas -
Analysis 6.1

Comparison 6 personalised risk communication versus general risk information for COLORECTAL SCREENING, Outcome 1 uptake of screening test.

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Comparison 7 personalised risk communication versus general risk information for PROSTATE CANCER SCREENING, Outcome 1 uptake of screening test.
Figuras y tablas -
Analysis 7.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva
Comparison 1. personalised risk communication versus general risk information

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 knowledge regarding screening test / condition concerned Show forest plot

2

568

Mean Difference (IV, Fixed, 95% CI)

2.45 [1.94, 2.96]

1.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

12.0 [6.89, 17.11]

1.3 personal risk factor list v general information

1

308

Mean Difference (IV, Fixed, 95% CI)

2.35 [1.84, 2.86]

2 knowledge regarding screening test / condition concerned Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.1 calculated risk score (numerical) v general information

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

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

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

3.1 calculated risk score (numerical) v general information

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

3.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 accurately perceived risk Show forest plot

3

1264

Odds Ratio (M‐H, Fixed, 95% CI)

1.46 [1.13, 1.88]

4.1 calculated risk score (numerical) v general information

2

1004

Odds Ratio (M‐H, Fixed, 95% CI)

1.22 [0.91, 1.64]

4.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

2.50 [1.48, 4.20]

4.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

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

2

499

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.30, 0.25]

5.1 calculated risk score (numerical) v general information

1

239

Mean Difference (IV, Fixed, 95% CI)

‐4.1 [‐7.54, ‐0.66]

5.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 intention to take screening test Show forest plot

5

2016

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.71, 1.03]

8.1 calculated risk score (numerical) v general information

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

1.10 [0.63, 1.94]

8.2 calculated risk score (categorised) v general information

2

538

Odds Ratio (M‐H, Fixed, 95% CI)

1.68 [1.12, 2.53]

8.3 personal risk factor list v general information

2

1264

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.54, 0.84]

9 uptake of screening test Show forest plot

14

7341

Odds Ratio (M‐H, Fixed, 95% CI)

1.13 [1.02, 1.24]

9.1 calculated risk score (numerical) v general information

2

1234

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.65, 1.03]

9.2 calculated risk score (categorised) v general information

2

1031

Odds Ratio (M‐H, Fixed, 95% CI)

1.42 [1.07, 1.89]

9.3 personal risk factor list v general information

10

5076

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [1.04, 1.32]

10 appropriate use of cholesterol test Show forest plot

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]

10.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]

11 smoking Show forest plot

1

204

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.60, 1.82]

11.1 calculated risk score (numerical) v general information

1

204

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.60, 1.82]

11.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 stages of change Show forest plot

Other data

No numeric data

12.1 personal risk factor list v general information

Other data

No numeric data

13 improvement in risk comprehension/perception Show forest plot

1

200

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.64 [0.83, 3.25]

13.1 calculated risk score (numerical) v general information

1

200

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.64 [0.83, 3.25]

13.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

13.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

14 making a recommended behaviour change Show forest plot

1

890

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.76, 1.28]

14.1 personal risk factor list v general information

1

890

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.76, 1.28]

14.2 calculated risk score(categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

14.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 1. personalised risk communication versus general risk information
Ir a la tabla de la revisión
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

984

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.45, 0.74]

1.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

984

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.45, 0.74]

2 uptake of screening test Show forest plot

3

1552

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.50, 0.77]

2.1 calculated risk score (numerical) v general information

1

296

Odds Ratio (M‐H, Fixed, 95% CI)

1.26 [0.75, 2.13]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

2

1256

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.42, 0.67]
Figuras y tablas -
Comparison 2. personalised risk communication versus general risk information for PAP SMEARS
Ir a la tabla de la revisión
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

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 knowledge regarding screening test / condition concerned Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.1 calculated risk score (numerical) v general information

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.95, 2.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 accuracy of perceived risk Show forest plot

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.86, 1.60]

3.1 calculated risk score (numerical) v general information

1

804

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.86, 1.60]

3.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 anxiety

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

1

478

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.36, 0.76]

7.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 personal risk factor list v general information

1

478

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.36, 0.76]

8 uptake of screening test Show forest plot

11

5234

Odds Ratio (M‐H, Fixed, 95% CI)

1.11 [0.98, 1.24]

8.1 calculated risk score (numerical) v general information

3

1456

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.66, 1.02]

8.2 calculated risk score (categorised) v general information

1

753

Odds Ratio (M‐H, Fixed, 95% CI)

1.37 [1.02, 1.84]

8.3 personal risk factor list v general information

7

3025

Odds Ratio (M‐H, Fixed, 95% CI)

1.22 [1.04, 1.43]

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

10 anxiety (Cancer related anxiety and helplessness scale)

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 improvement in risk comprehension/perception

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.1 calculated risk score (numerical) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. personalised risk communication versus general risk information for MAMMOGRAPHY
Ir a la tabla de la revisión
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

1

276

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.57, 1.65]

1.1 calculated risk score (numerical) v general information

1

276

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.57, 1.65]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 appropriate use of cholesterol test Show forest plot

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]

2.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

1

3152

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [1.14, 1.55]
Figuras y tablas -
Comparison 4. personalised risk communication versus general risk information for CHOLESTEROL TESTS
Ir a la tabla de la revisión
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

2

568

Mean Difference (IV, Fixed, 95% CI)

2.45 [1.94, 2.96]

1.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

12.0 [6.89, 17.11]

1.3 personal risk factor list v general information

1

308

Mean Difference (IV, Fixed, 95% CI)

2.35 [1.84, 2.86]

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

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

2.1 calculated risk score (numerical) v general information

1

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.35, 1.19]

2.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 personal risk factor list v general information

0

0

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]

3.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 anxiety Show forest plot

2

499

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.30, 0.25]

4.1 calculated risk score (numerical) v general information

1

239

Mean Difference (IV, Fixed, 95% CI)

‐4.1 [‐7.54, ‐0.66]

4.2 calculated risk score (categorised) v general information

1

260

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.28, 0.28]

4.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 satisfaction with decision

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 decision conflict

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 intention to take screening test Show forest plot

2

540

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.55, 1.27]

7.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 calculated risk score (categorised) v general information

1

260

Odds Ratio (M‐H, Fixed, 95% CI)

0.21 [0.07, 0.65]

7.3 personal risk factor list v general information

1

280

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.72, 1.89]

8 uptake of screening test Show forest plot

5

3145

Odds Ratio (M‐H, Fixed, 95% CI)

1.45 [1.23, 1.71]

8.1 calculated risk score (numerical) v general information

2

1355

Odds Ratio (M‐H, Fixed, 95% CI)

1.48 [1.06, 2.07]

8.2 calculated risk score (categorised) v general information

1

753

Odds Ratio (M‐H, Fixed, 95% CI)

1.37 [1.02, 1.84]

8.3 personal risk factor list v general information

2

1037

Odds Ratio (M‐H, Fixed, 95% CI)

1.49 [1.16, 1.91]

9 improvement in risk comprehension/perception

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.1 calculated risk score (numerical) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 calculated risk score(categorised) v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.3 personal risk factor list v general information

0

0

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 anxiety (Cancer related anxiety and helplessness scale)

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.1 calculated risk score (numerical) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 calculated risk score (categorised) v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 personal risk factor list v general information

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 5. personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE
Ir a la tabla de la revisión
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 uptake of screening test Show forest plot

1

278

Odds Ratio (M‐H, Fixed, 95% CI)

2.09 [0.76, 5.75]

1.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

1

278

Odds Ratio (M‐H, Fixed, 95% CI)

2.09 [0.76, 5.75]

1.3 personal risk factor list v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 6. personalised risk communication versus general risk information for COLORECTAL SCREENING
Ir a la tabla de la revisión
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

413

Odds Ratio (M‐H, Fixed, 95% CI)

2.56 [1.70, 3.84]

1.1 calculated risk score (numerical) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 calculated risk score (categorised) v general information

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 personal risk factor list v general information

1

413

Odds Ratio (M‐H, Fixed, 95% CI)

2.56 [1.70, 3.84]
Figuras y tablas -
Comparison 7. personalised risk communication versus general risk information for PROSTATE CANCER SCREENING
Ir a la tabla de la revisión