Personalised risk communication for informed decision making about taking screening tests

Adrian GK Edwards; Rhodri Evans; Kerry Hood; Glyn J Elwyn

doi:10.1002/14651858.CD001865.pub2

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Analysis 1.1

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

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Analysis 1.2

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

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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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Analysis 1.4

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

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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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Analysis 1.8

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

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Analysis 1.9

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

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Analysis 1.10

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

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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.

Analysis 1.12

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

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Analysis 1.13

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

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Analysis 1.14

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

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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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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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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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Analysis 3.3

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

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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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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.

Analysis 3.9

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

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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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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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Analysis 5.1

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

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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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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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Analysis 5.4

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

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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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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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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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Analysis 7.1

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

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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]

Comparison 1. personalised risk communication versus general risk information

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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]

Comparison 2. personalised risk communication versus general risk information for PAP SMEARS

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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]

Comparison 3. personalised risk communication versus general risk information for MAMMOGRAPHY

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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]

Comparison 4. personalised risk communication versus general risk information for CHOLESTEROL TESTS

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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]

Comparison 5. personalised risk communication versus general risk information for 'HIGH RISK' PEOPLE

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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]

Comparison 6. personalised risk communication versus general risk information for COLORECTAL SCREENING

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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]

Comparison 7. personalised risk communication versus general risk information for PROSTATE CANCER SCREENING

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