Everyone loves to work smarter, not harder, especially when doing so delivers solid outcomes. One example: multi-cancer early detection (MCED) tests which are good at detecting cancers for which there are no other screening tests. However, some cancer screenings can result in lead time bias, false positive results, and overdiagnosis, raising questions about MCED tests and their efficacy, especially as Congress considers a bill that would guarantee Medicaid covers the cost of MCED tests.
Enter Laura Scherer, PhD, associate professor of cardiology at the University of Colorado Anschutz School of Medicine and associate director of the Patient-Centered Decisions Core at the Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), and her research addressing patient-centered care and shared decision-making.
A psychologist by training whose fascination in how patients make decisions led her to working in health services research, Scherer is now turning her attention to MCED tests.
With the support of Arnold Ventures, Scherer plans to create and distribute two surveys to better understand attitudes and understanding around MCED tests among primary care physicians and the general U.S. population. Each survey’s implementation will inform the conversation around what people think about the current evidence for MCED tests and how interested people are in having these tests.
As part of the clinician survey, Scherer aims to understand primary care physicians’ knowledge and attitudes towards MCED tests, especially where they fall in terms of their excitement about the test, and their attitudes towards it before and after being informed of the evidence.
Primary care physicians, who must stay abreast of innovation and breakthroughs in multiple fields across medicine to best serve their patients, might not read every single piece of scientific literature available on a specific topic. Instead, they tend to refer to best practices or a set of guidelines. Scherer wants to know, once the primary care physician is informed about MCED tests, what they think of the test.
As part of the general population study, Scherer wants to understand U.S. patients’ understanding of and interest in MCED tests. She plans to assess how enthusiasm for MCED tests changes when people are provided with evidence. She wants to know if telling patients about the evidence shapes how they feel about the test, and if it might change their mind about getting the test.
Why does it matter? Scherer’s reasoning is simple: “Having an informed patient population and a really well-informed clinician population can potentially change the total number of people who are interested in these tests.”
Scherer continues, “If it’s the case that a lot of people would change their excitement or decision around the test [after] having been informed, then that suggests that people need to get that information before they can consent to the test.”
This line of thinking touches on the reasonable-patient standard, which asserts that patients should be provided with information a reasonable person would want to know before consenting to a medical intervention.
“Informing people about the evidence might cause them to make a different decision” is at the heart of Scherer’s work – understanding why people make the decisions they do about health care.