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Many men still confuse benign prostatic hyperplasia with prostate cancer, even after viewing an instructional videotape

Decision aids can increase a patient's knowledge about a particular medical condition or procedure, including its possible benefits and harms, but they don't always work, according to a new study supported in part by the Agency for Healthcare Research and Quality (HS10608). Researchers found that some men who watched a video about treatment for benign prostatic hyperplasia (BPH, enlarged prostate) still considered BPH and prostate cancer related to one another, despite explicit statements to the contrary in the video. Overall improved knowledge using decision aids may mask incorrect theories of disease process, suggests Margaret Holmes-Rovner, Ph.D., of Michigan State University.

Dr. Holmes-Rovner and fellow investigators analyzed transcripts from interviews about BPH treatment with a racially and ethnically diverse group of 188 men. First, the men completed a survey which measured BPH and prostate cancer knowledge, health literacy, BPH symptoms, and demographic characteristics. The men then watched an educational videotape about BPH treatment, which identified BPH as different from prostate cancer; it explicitly said the video was NOT about cancer. They then participated in a semi-structured interview while watching the video and a postvideo debriefing.

During the interviews, 18 of the men spontaneously talked about BPH and cancer as related to each other. Pre- and post-video survey responses suggested that up to 67 percent of the men persisted in misconceptions even after viewing the video. The researchers identified three basic misconceptions voiced by men while viewing the videotape: BPH and cancer are similar, BPH surgery is for removing cancer, and BPH leads to cancer. The researchers call for more studies to identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based decision aids.

More details are in "Men's theories about benign prostatic hyperplasia and prostate cancer following a benign prostatic hyperplasia decision aid," by Dr. Holmes-Rovner, Chrystal Price, B.A., B.S., David R. Rovner, M.D., and others, in the January 2006 Journal of General Internal Medicine 21, pp. 56-60.

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