Programme no. 502-SY
Public Health
The healthy individual in preventive medicine – a symposium about individuals’ preferences and relevant evidence in screening
Minna Johanson1, Jakob F Rasmussen2, Bruno Heleno*3, Mie Hestbech4, Carlos Martins5, John Brodersen6
1Department of Public Health and Community Medicine,University of Gothenburg,Gothenburg,Sweden, 2Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 3Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark;Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 4Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 5Social Sciences and Health Department,University of Porto,Porto,Portugal, 6Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark
* = Presenting author
Symposium
Objectives:


Background: Decisions about healthcare should respect peoples’ preferences – especially when it comes to healthy individuals. However, these preferences may be grounded in unreasonable expectations of the outcomes of tests and examinations. Clinicians may feel frustrated when addressing these expectations and a number of problems can complicate this dilemma. Firstly, appropriate evidence on relevant outcomes is difficult to find. Secondly, to have an impact on individuals’ preferences, the available evidence needs to be tailored to fit the individual’s information needs. Thirdly, the impact of preferences in final healthcare decisions is difficult to foresee. In this symposium we will investigate these problems via different examples of screening of healthy individuals: abdominal aortic aneurism (AAA), cervical cancer and lung cancer screenings.
Content: We will present what are the general population beliefs about benefits and harms of screening. People seem enthusiastic about getting tested for everything technology has to offer. Part of the reason may be due to scarce information about harms of screening. Overdiagnosis is the major harm, and we will explain how it was possible to find and report information about overdiagnosis in screening for AAA. Although overdiagnosis is the major harm of screening, this information was not readily available in the trial reports. We are aware that generating evidence is not enough to have an impact on people’s decisions. We will present a project that tries to identify what are the knowledge and information needs of invitees to cervical cancer screening. Finally, we will try to illustrate why incorporating patient preferences in decisions about lung cancer screening may not be an attainable goal.
Method: A mix of lectures, small group discussion and plenum discussion will be used. This will include five case studies derived from the workshop authors’ own research. In small groups, participants will be invited to discuss these cases in relation to their own beliefs, clinical experience and theoretical knowledge. Plenum discussion will be used to share the main results of small group work and summarize workshop results.
Other considerations: None.