What Improves Md Cancer Screening Recommendations?

e13547Background: Guidelines provide guidance but patient (PT) medical factors and preferences alter recommendations. We studied PT factors that alter the correct recommendation (CR) and physician (MD) advice in real-time cancer breast, colorectal, cervical, lung and prostate cancer screening discussions in a 2x2 cluster-randomized trial of MD educational supports. Methods: We enrolled an age- (30-49, 50-69, 70-89 years) and sex-stratified sample of 18 patients (PTs) who underwent a physical examination at 2 urban hospitals by each of 12 primary care MDs. We assigned screening guideline formatting (color-coding [CC]) and academic detailing (AD) to MDs randomly. Immediate post-encounter surveys recorded PT and MD recall of screening discussions. We classified recommendations (CR) conservatively. PSA screening recommendations were classified as incorrect only when against screening, for men too old ( u003e 75 yrs) or too young (African American [AA] u003c 40 or non-AA u003c 50). For other men, either was considered cor...