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NCT04683731

Helping Patients and Providers Make Better Decisions About Colorectal Cancer Screening

Completed NA Results posted Last updated 13 December 2024
What this trial tests

NA trial testing Decision aid without personalized message in Cancer Screening Tests in 1,111 participants. Completed in 31 July 2023.

Timeline
19 January 2021
Primary endpoint
17 May 2023
31 July 2023

Quick facts

Lead sponsorIndiana University
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposescreening
Enrollment1,111
Start date19 January 2021
Primary completion17 May 2023
Estimated completion31 July 2023
Sites2 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Indiana University

Who can join

Adults 50 to 75, any sex, with Cancer Screening Tests. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants Who Completed Colorectal Cancer Screening Primary · 6 months after patient enrollment

Patients' completion of colonoscopy, fecal immunochemical testing (FIT), or other CRC screening within 6 months, based on documentation in the participants' electronic health record.

GroupValue95% CI
Group 1110
Group 295
Group 3113
Group 4113
Number of Participants Who Made a High Quality Decision Using the Multi-dimensional Measure of Informed Consent (MMIC) Which Incorporates Knowledge, Intent, and Behavior. Primary · 6 months after participant enrollment

Decision quality will be assessed using the multi-dimensional measure of informed consent (MMIC), where a high-quality decision is one where the individual has adequate knowledge regarding the available options and undergoes the screening test that he or she has chosen or that fits his or her values ("values concordance"). Patient knowledge of colorectal cancer and screening will be assessed by a 12-item test made up of 6 multiple choice questions and 6 true-false questions. Adequate knowledge = 9 correct. Concordance will be measured between the patient's test choice at the post-provider surv

GroupValue95% CI
Group 190
Group 292
Group 391
Group 4103
Number of Participants Who Completed Colorectal Cancer Screening by Type of Screening Test Completed Secondary · 6 months after participant enrollment

Colorectal cancer (CRC) screening uptake and type of screening test completed within 6 months of enrolled was assessed, as documented in the electronic health record (EHR).

GroupValue95% CI
Group 159
Group 239
Group 352
Group 451
Group 151
Group 256
Group 361
Group 462
Group 1180
Group 2167
Group 3134
Group 4172
Average Intention to Get a Colorectal Cancer (CRC) Screening Test of Participants: Change Between Baseline, Post-intervention, and Post-provider Visit Secondary · 1 day (immediately before viewing intervention [baseline/T1] and after viewing intervention [post-intervention/T1]); and approximately 4-30 days after viewing intervention and 4-14 days after provider visit (post-provider visit/T2)

Patients' intention to be screened for CRC with any CRC screening test will be measured with 1 item: "Do you plan to get any type of colon cancer screening test within the next 6 months?". The response options were: 5=Definitely; 4=Probably; 3=May or may not; 2=Probably not; and 1=Definitely not. Higher positive change means CRC screening intention increased. Increased intention to be screened is a better outcome.

Change from baseline (T0) to post-intervention (T1)
GroupValue95% CI
Group 10.59± 0.79
Group 20.68± 0.86
Group 30.55± 0.84
Group 40.63± 0.83
Change from post-intervention (T1) to post-provider visit (T2)
GroupValue95% CI
Group 10.23± 0.93
Group 20.24± 0.74
Group 30.24± 0.82
Group 40.20± 0.79
Change from baseline (T0) to post-provider visit (T2)
GroupValue95% CI
Group 10.85± 1.18
Group 20.94± 1.01
Group 30.80± 1.15
Group 40.82± 1.05
Number of Participants Intended Colorectal Cancer (CRC) Screening Behavior Secondary · 1 day (immediately before viewing intervention [baseline/T1] and after viewing intervention [post-intervention/T1]); and approximately 4-30 days after viewing intervention and 4-14 days after provider visit (post-provider visit/T2)

For those patients who answer the screening intent item with "definitely not," "probably not," or "may or may not", test choice will be categorized as "no screening". Those who answer Screening Intent with "Probably" or "Definitely" have Test Choice categorized based on their answer to a single item: "If you have a colon test, which one would you choose?" Response options are: Stool test (FIT or Cologuard), Colonoscopy, Another test, or Don't know.

Intended screening behavior at baseline (T0)
GroupValue95% CI
Group 170
Group 258
Group 356
Group 479
Group 162
Group 253
Group 355
Group 470
Group 12
Group 23
Group 32
Group 42
Group 137
Group 237
Group 335
Group 432
Intended screening behavior at post-intervention (T1)
GroupValue95% CI
Group 1106
Group 282
Group 393
Group 486
Group 185
Group 2106
Group 374
Group 4133
Group 10
Group 20
Group 31
Group 40
Group 125
Group 218
Group 319
Group 419
Intended screening behavior at post-provider (T2)
GroupValue95% CI
Group 1104
Group 290
Group 383
Group 489
Group 192
Group 284
Group 389
Group 4117
Group 11
Group 21
Group 30
Group 41
Group 16
Group 25
Group 32
Group 43
Average Correct Responses of Participants to Knowledge Questions About Colorectal Cancer (CRC) and CRC Screening: Change Between Baseline, Post-intervention, and Post-provider Visit. Secondary · 1 day (immediately before viewing intervention [baseline/T1] and after viewing intervention [post-intervention/T1]); and approximately 4-30 days after viewing intervention and 4-14 days after provider visit (post-provider visit/T2)

Knowledge was assessed with six multiple choice and six true/false questions regarding general information (including risk factors, screening test options, and test frequency) of CRC and CRC screening. Knowledge scores were derived by summing correct responses to the 12 individual knowledge questions (range, 0-12), and change was calculated from baseline (T0) to post-intervention (T1), post-intervention (T1) to post-provider visit (T2), and from baseline (T0) to post-provider (T2) by using the knowledge score at the later time point minus the knowledge score of the former time point. The range

Change in correct responses from baseline (T0) to post-intervention (T1)
GroupValue95% CI
Group 13.65± 2.68
Group 23.70± 2.74
Group 33.75± 2.82
Group 43.76± 2.90
Change in correct responses from post-intervention (T1) to post-provider visit (T2)
GroupValue95% CI
Group 1-0.60± 1.40
Group 2-0.58± 1.31
Group 3-0.60± 1.60
Group 4-0.43± 1.45
Change in correct responses from baseline (T0) to post-provider visit (T2)
GroupValue95% CI
Group 13.03± 2.71
Group 23.10± 2.79
Group 33.02± 3.02
Group 43.31± 2.83
Average Perceived Personal Colorectal Cancer Risk of Participants: Change Between Baseline, Post-intervention, and Post-provider Visit Secondary · 1 day (immediately before viewing intervention [baseline/T1] and after viewing intervention [post-intervention/T1]); and approximately 4-30 days after viewing intervention and 4-14 days after provider visit (post-provider visit/T2)

Multiple choice questions assessing the patients' perception of how likely they are to get colon cancer in the next 5 years, in the next 10 years, and sometime during their lifetime. Each has response options: 4=very likely, 3=somewhat likely, 2=somewhat unlikely, and 1=very unlikely. The mean of the 3 questions was calculated (each combined score has a range of 1 to 4) at each time point. We calculated the change from baseline (T0) to post-intervention (T1), post-intervention (T1) to post-provider visit (T2), and from baseline (T0) to post-provider (T2) by using the mean of the later time poi

Change from baseline (T0) to post-intervention (T1)
GroupValue95% CI
Group 10.21± 0.74
Group 20.15± 0.78
Group 30.14± 0.81
Group 40.08± 0.77
Change from post-intervention (T1) to post-provider visit (T2)
GroupValue95% CI
Group 1-0.10± 0.86
Group 20.12± 0.82
Group 30.10± 0.87
Group 40.05± 0.83
Change from baseline (T0) to post-provider visit (T2)
GroupValue95% CI
Group 10.14± 0.79
Group 20.28± 0.87
Group 30.21± 0.98
Group 40.14± 0.84
Average Decision Conflict of Participants: Change Between Baseline, Post-intervention, and Post-provider Visit Secondary · 1 day (immediately before viewing intervention [baseline/T1] and after viewing intervention [post-intervention/T1]); and approximately 4-30 days after viewing intervention and 4-14 days after provider visit (post-provider visit/T2)

Patients' decision conflict is assessed using the low literacy version of the Decision Conflict Scale, a ten-item instrument that assesses patients' subjective feeling regarding the decision process over five areas. Each item has three response categories (yes, no, unsure). Scores are summed; divided by 10; and multiplied by 25. Scores range from 0 \[no decisional conflict\] to 100 \[extremely high decisional conflict\]. Negative change means decision conflict decreased. A decrease in decision conflict is a better outcome.

Change from baseline (T0) to post-intervention (T1)
GroupValue95% CI
Group 1-36.6± 28.9
Group 2-42.4± 27.6
Group 3-37.1± 27.7
Group 4-40.3± 28.4
Change from post-intervention (T1) to post-provider visit (T2)
GroupValue95% CI
Group 1-1.60± 12.1
Group 2-0.76± 9.53
Group 3-2.32± 11.6
Group 4-0.27± 11.6
Change from baseline (T0) to post-provider visit (T2)
GroupValue95% CI
Group 1-39.0± 29.2
Group 2-41.6± 28.8
Group 3-37.9± 29.2
Group 4-39.3± 29.2
Number of Participants Who Perceive Being Involved in Shared-Decision Making as Assessed by the Shared Decision Making Process Survey-4 Secondary · approximately 4-30 days after viewing intervention and 4-14 days after provider visit [post-provider visit/T2]

Patients answered four items assessing the extent to which they were involved in the decision-making process. Each item had response options: 1= A lot; 2=Some; 3=A little; 4=Not at all. Each item was analyzed separately and responses "A lot", "Some" and "A little" were considered "enough" and received 1 point. The response "Not at all" was considered "not enough" and received 0 points.

How much did you and your provider talk about the reasons you might want to have a colonoscopy?
GroupValue95% CI
Group 1203
Group 2178
Group 3164
Group 4201
Group 126
Group 228
Group 335
Group 435
Group 161
Group 256
Group 348
Group 449
How much did you and your provider talk about the reasons you might not want to have a colonoscopy?
GroupValue95% CI
Group 1106
Group 289
Group 391
Group 4119
Group 1123
Group 2117
Group 3108
Group 4117
Group 161
Group 256
Group 348
Group 449
How much did you and your provider talk about the reasons you might want to do a stool test?
GroupValue95% CI
Group 1160
Group 2146
Group 3146
Group 4173
Group 169
Group 260
Group 352
Group 463
Group 161
Group 256
Group 349
Group 449
How much did you and your provider talk about the reasons you might not want to do a stool test?
GroupValue95% CI
Group 1108
Group 292
Group 393
Group 4111
Group 1121
Group 2114
Group 3106
Group 4124
Group 161
Group 256
Group 348
Group 450
Number of Participants Who Perceive Being Involved in Shared-Decision Making as Assessed by the Decision Quality Instrument Secondary · approximately 4-30 days after viewing intervention and 4-14 days after provider visit [post-provider visit/T2]

A single-item measure taken from the Colon Cancer Testing Decision Quality Worksheet v.2.0 assessing if the patients' primary care provider asked them which type of colon cancer screening test they wanted.

GroupValue95% CI
Group 1152
Group 2134
Group 3130
Group 4159
Group 176
Group 272
Group 369
Group 477
Group 162
Group 256
Group 348
Group 449
Participant's Average Perception of Shared-Decision Making as Assessed by CollaboRATE Secondary · approximately 4-30 days after viewing intervention and 4-14 days after provider visit [post-provider visit/T2]

A 3-item measure assessing how much effort was made by their provider to: explain colon cancer screening, ask for screening preferences, and incorporate those preferences into the decision. Response options ranged from 0="No effort was made" to 9="Every effort was made". The three items were summed and a mean was calculated. Scores can range from 0-9. A higher score indicates more perceived shared decision making. Higher perceived shared decision making is a better outcome.

GroupValue95% CI
Group 16.4± 3.1
Group 26.3± 3.2
Group 36.3± 3.2
Group 46.5± 3.0
Number of Participants With Orders for a Colorectal Cancer Screening (CRC) Test Secondary · 6 months after patient enrollment

A FIT, colonoscopy, or other CRC screening test ordered within 6 months of each participants' enrollment based on documentation in the electronic health record (EHR).

GroupValue95% CI
Group 189
Group 284
Group 379
Group 484
Group 1201
Group 2178
Group 3168
Group 4201

Sponsor's own description

Precision prevention holds great promise for colorectal cancer (CRC) screening but has not been adequately explored. A patient's chance of having an advanced colorectal neoplasm (ACN), i.e. a cancer or precancerous polyp in the colon, significantly affects the comparative effectiveness of approved tests. Giving patients a decision aid with information about their risk for ACN, and giving their providers similar information, could help patients and providers decide if colonoscopy or a non-invasive test (such as the fecal immunochemical test) is more appropriate. This could improve decision making and increase uptake of CRC screening, which are the investigative team's long-term goals.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Effect of Personalized Risk Messages on Uptake of Colorectal Cancer Screening : A Randomized Controlled Trial.
    Schwartz PH, Perkins SM, Rawl SM, Schmidt KK, et al · · 2025 · PMID 40889370 · DOI 10.7326/annals-24-03144

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04683731.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing