Informed choice about breast cancer prevention: randomized controlled trial of an online decision aid intervention.

Journal Article (Clinical Trial;Journal Article)


Tamoxifen and raloxifene are chemopreventive drugs that can reduce women’s relative risk of primary breast cancer by 50%; however, most women eligible for these drugs have chosen not to take them. The reasons for low uptake may be related to women’s knowledge or attitudes towards the drugs. We aimed to examine the impact of an online breast cancer chemoprevention decision aid (DA) on informed intentions and decisions of women at high risk of breast cancer.


We conducted a randomized clinical trial, assessing the effect of a DA about breast cancer chemoprevention on informed choices about chemoprevention. Women (n = 585), 46- to 74-years old old, completed online baseline, post-test, and three-month follow-up questionnaires. Participants were randomly assigned to either an intervention group, a standard control group that answered questions about chemoprevention at baseline, or a three-month control group that did not answer questions about chemoprevention at baseline. The main outcome measures were whether women’s intentions and decisions regarding chemoprevention drugs were informed, and whether women who viewed the DA were more likely to make informed decisions than women who did not view the DA, using a dichotomous composite variable ‘informed choice’ (yes/no) to classify informed decisions as those reflecting sufficient knowledge and concordance between a woman’s decision and relevant attitudes.


Analyses showed that more intervention than standard control participants (52.7% versus 5.9%) made informed decisions at post-test, P <0.001. At the three-month follow-up, differences in rates of informed choice between intervention (16.9%) and both control groups (11.8% and 8.0%) were statistically non-significant, P = 0.067.


The DA increased informed decision making about breast cancer chemoprevention, although the impact on knowledge diminished over time. This study was not designed to determine how much knowledge decision makers must retain over time. Examining informed decisions increases understanding of the impact of DAs. A standard for defining and measuring sufficient knowledge for informed decisions is needed.

Trial registration NCT00967824

Full Text

Duke Authors

Cited Authors

  • Korfage, IJ; Fuhrel-Forbis, A; Ubel, PA; Zikmund-Fisher, BJ; Greene, SM; McClure, JB; Smith, DM; Alford, SH; Fagerlin, A

Published Date

  • January 2013

Published In

Volume / Issue

  • 15 / 5

Start / End Page

  • R74 -

PubMed ID

  • 24004815

Pubmed Central ID

  • PMC3978729

Electronic International Standard Serial Number (EISSN)

  • 1465-542X

International Standard Serial Number (ISSN)

  • 1465-5411

Digital Object Identifier (DOI)

  • 10.1186/bcr3468


  • eng