Patient decision making: An evaluation of two different methods of presenting information about a screening test

Andrew McClennan2 Objectives. To assess the impact upon women's decisions of presenting information about a screening test for Down syndrome in different ways. Design. Random allocation to one of four conditions: simple leaflet only, simple leaflet + video, expanded leaflet, expanded leaflet + video. Methods. Three hundred and twenty‐four women who were eligible for the test and for the study participated. Leaflets, and videos if appropriate, were given by midwives during booking consultations for participants to take home. The outcome measures were knowledge, change in knowledge, process of decision making, test uptake, anxiety, change in anxiety, and satisfaction with decision made. Results. The interventions had no effect on any of the outcome measures. Conclusions. These results show that the addition of a video or expanded leaflet does not confer any benefit in terms of knowledge, decision making or anxiety to women being offered serum screening for Down syndrome. This suggests that we should not accept at face value the seemingly positive contribution of videos as aids to information giving and decision making. The results also have implications for the way the decisionmaking process is conceptualized, an issue in urgent need of further study.