Department of Psychological Sciences, University of Missouri, Columbia MO, USA.
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Med Decis Making. 2018 Aug;38(6):708-718. doi: 10.1177/0272989X18782199. Epub 2018 Jun 19.
The recently developed Medical Maximizer-Minimizer Scale (MMS) assesses individual differences in preferences for active v. passive medical treatment. We hypothesized that men's maximizing-minimizing preferences might have relevance in the case of prostate-specific antigen (PSA) screening, since there is considerable variability in men's preference for being screened even among men who are informed that harm is more likely than benefit. The current research examined whether MMS preferences predict how men respond to didactic information and narrative stories about PSA screening.
US men 40+ years old ( N = 1208) participated in an online survey. Men viewed information about PSA screening in 3 phases and provided their preference for screening after each phase. Phase 1 described what PSA screening is. Phase 2 added didactic information about screening risks and benefits. Phase 3 added narrative stories; men were randomized to receive stories about 1) physical harm, 2) emotional harm, 3) overdiagnosis, or 4) all 3 stories. Participants also completed the validated MMS.
After receiving basic information, 76.8% of men wanted PSA screening. After receiving information about risks and benefits, 54.8% wanted screening (a significant reduction, P < 0.001). Men who changed their preferences were significantly more likely to be minimizers than maximizers; most men with maximizing tendencies wanted screening after both the didactic information and narratives, whereas most men with minimizing tendencies did not want the test after receiving information.
Men who prefer a more minimizing approach to medicine are more responsive to evidence supporting limiting or forgoing screening than men who prefer a maximizing approach.
最近开发的医疗最大化-最小化量表（MMS）评估了个体对主动与被动医疗治疗偏好的差异。我们假设，在前列腺特异性抗原（PSA）筛查方面，男性的最大化-最小化偏好可能具有相关性，因为即使在告知男性筛查的危害可能性大于益处的情况下，男性对筛查的偏好也存在很大差异。目前的研究检验了 MMS 偏好是否可以预测男性对 PSA 筛查的教学信息和叙述性故事的反应。
我们招募了美国 40 岁以上的男性（N=1208）参与在线调查。男性在三个阶段查看有关 PSA 筛查的信息，并在每个阶段后提供他们对筛查的偏好。第一阶段描述了 PSA 筛查是什么。第二阶段增加了关于筛查风险和益处的教学信息。第三阶段增加了叙述性故事；男性被随机分配阅读关于 1）身体伤害、2）情绪伤害、3）过度诊断或 4）所有 3 个故事的内容。参与者还完成了经过验证的 MMS。
在收到基本信息后，76.8%的男性希望进行 PSA 筛查。在收到有关风险和益处的信息后，54.8%的男性希望进行筛查（显著减少，P<0.001）。改变偏好的男性更有可能是最小化者而不是最大化者；大多数具有最大化倾向的男性在收到教学信息和叙述性故事后都希望进行筛查，而大多数具有最小化倾向的男性在收到信息后并不希望进行测试。
与喜欢最大化方法的男性相比，更喜欢更具最小化方法的男性对支持限制或放弃筛查的证据更敏感。
