Purpose: To assess the usefulness of a multi criteria decision analysis (MCDA)-based tool amongst General Practitioners.
Method: In this exploratory study, a small number of computer-savvy primary care physicians (GPs) were selected from a random national sample of 1000 GPs. A formal scripted interview was conducted with each GP using a computer-based decision tool (MCDA as implemented in Annalisa©) with prostate cancer screening as the root topic. The evidence (ratings) panel was populated from recently published trial data on prostate cancer screening. The preferences (weightings) panel was completed by the GP during the interview. After ‘hands-on’ experience with the tool, each GP was asked a series of standardized stem questions relating to their perceived usefulness of the MCDA approach as implemented. GPs were presented initially with the MCDA using a relative risk reduction estimate of the reduction in prostate cancer-related mortality and subsequently with an MCDA based on absolute risk. Finally, each GP was asked to rate nine statements on the information and decision making usefulness of the MCDA using a five point Likert scale.
Result: Six male (average age 55.3 yrs) and 4 female (average age 53 yrs) GPs completed an interview. In assessing its usefulness, 90% either agreed or strongly agreed that it was easy to understand, 80% either agreed or strongly agreed that it was useful to decision making and 50% either agreed or strongly agreed that they would recommend the MCDA to their patients. When asked which prostate cancer MCDA they would use with their patients, 20% said they would use the ‘relative risk’ MCDA and 10% would use ‘absolute risk’. 70% of GPs commented that they were unsure about the difference between relative and absolute risk measures and/or the significance of the ‘relative risk’ versus ‘absolute risk’ attribute on the scores.
Conclusion: The MCDA shows good potential as a means by which GPs can combine evidence with patient preferences in making a clinical decision. The GPs found Annalisa useful but did not have a good understanding about the use of relative versus absolute risk in quantifying the benefits of prostate cancer screening. This study was funded by a NHMRC Program Grant No 402764. Jack Dowie has a commercial interest in the Annalisa© software
Candidate for the Lee B. Lusted Student Prize Competition