A tale of two studies: the importance of setting, subjects and context in two randomized, controlled trials of a web-based decision support for perimenopausal and postmenopausal health decisions

UMMS Affiliation

Meyers Primary Care Institute; Department of Family Medicine and Community Health

Publication Date


Document Type



Aged; Computer-Assisted Instruction; Conflict (Psychology); *Decision Support Techniques; Estrogen Replacement Therapy; Female; Health Knowledge, Attitudes, Practice; Humans; Internet; Middle Aged; Pamphlets; Patient Education as Topic; *Patient Satisfaction; Perimenopause; Postmenopause; Questionnaires; Risk Assessment; Teaching Materials; Uncertainty; United States; Women


Community Health and Preventive Medicine | Health Services Research | Primary Care


OBJECTIVE: Knowledge relevant to women's peri- and postmenopausal health decisions has been evolving rapidly. Web-based decision supports can be rapidly updated and have the potential to improve the quality of patients' decisions. We developed and tested a web-based decision support for peri- and postmenopausal health decisionmaking.

METHODS: We recruited 409 women aged 45-75 for one randomized, controlled trial and 54 women with an upcoming clinic appointment for a subsequent trial. Women were randomized to use the web-based decision support versus a printed brochure (first trial) and usual care (second trial). Outcomes were changes in decisional satisfaction, decisional conflict, and knowledge, both within each trial and compared across the trials.

RESULTS: Intervention subjects had greater increases in decisional satisfaction in the second trial and knowledge in both trials. A high dropout rate among women randomized to the website in the first trial effectively negated benefits in that trial, but not in the second.

CONCLUSIONS: The utility of this web-based decision support in two trials depended on a number of factors that appear related to the urgency of making a decision.

PRACTICE IMPLICATIONS: Decision aids should be targeted to patients actively trying to make a decision.

DOI of Published Version



Patient Educ Couns. 2007 May;66(2):211-22. Epub 2007 Feb 20. Link to article on publisher's site

Journal/Book/Conference Title

Patient education and counseling

Related Resources

Link to Article in PubMed

PubMed ID