Value attribution in the decision to use of whole body mri for early cancer diagnosis

Abstract

This study aimed to identify the main factors that asymptomatic individuals considered when deciding to undergo self-referred Whole-body MRI (WB-MRI) for early cancer diagnosis and the subjective values attributed to each mentioned factor in a Decision tree analysis. Personal characteristics such as risk perception and personality were investigated as possible factors affecting value attribution. Seventy-four volunteers (mean age 56.4; male = 47) filled a simplified decision tree by expressing the expected factors and related subjective values associated with two screening options for early cancer diagnosis (standard procedures vs. WB-MRI+standard procedures) while waiting for a WB-MRI examination. Questionnaires on risk perception and personality traits were also administered. Expected factors were summarized in 5 clusters: diagnostic certainty, psychological well-being, safety, test validity and time/cost. Test validity and time/cost were evaluated as potential losses in both procedures. Diagnostic Certainty and safety were evaluated as losses in standard screening, and as an advantage when considering WB-MRI+standard screening. Forty-five percent of participants considered WB-MRI+standard screening as beneficial for their psychological well-being. Finally, personal absolute and comparative risk to get cancer was associated with a positive value attribution to WB-MRI (p < 0.05). Our results showed the addition of WB-MRI to be generally considered a good option to increase individuals’ perceptions of diagnostic certainty and the safety of the exam, and to increase psychological well-being. The positive value of such a screening option increased with the individual’s cancer risk perception.