In Portugal, a NOVA Medical School research project aimed at supporting informed decisions about cancer screening will be implemented in clinical practice through a digital platform to be tested in primary healthcare centres over the next 24 months.
The DECIDE-SCREEN project, funded by the “la Caixa” Foundation, aims to provide patients with information on the benefits, risks, and limitations of cancer screening, enabling them to make better decisions together with healthcare professionals.
The DECIDE-SCREEN project — Digital Decision Aids to Support Informed Decisions on Cancer Screening in Primary Care: A Pilot Study — is coordinated by the Value for Health Collaborative Laboratory (VOH.CoLAB), in partnership with NOVA Medical School and the Western Lisbon Local Health Unit (ULSLO). It was one of the initiatives selected for funding under the la Caixa Foundation HealthCare Research Call 2026.
The platform, which will be tested at a primary care facility in the western Lisbon area, will automatically identify individuals eligible for specific cancer screenings and send them, via SMS or email, decision support tools based on the best available scientific evidence. The goal is to allow each person to learn about the different options in advance, reflect on them at their own pace, and arrive better prepared for the moment of decision, rather than having to process all the information during a single medical appointment.
In the first phase, the platform will focus on two patient decision aids: one for cervical cancer screening and one for colorectal cancer screening (two of the most common cancers in Portugal, both covered by national screening programs). These tools will provide clear, balanced, and accessible information, helping individuals understand what to expect and prepare for a more informed conversation with their doctor.
Deciding on cancer screening is not just about choosing whether or not to have a test. It means understanding the potential benefits of screening, as well as its limitations and possible risks. At other times, it involves choosing between different strategies when more than one clinically appropriate option exists. We want this information to reach people before their appointment, so they can reflect on it and participate more actively and knowledgeably in decisions about their health, in line with their values and preferences,
Bruno Heleno, family physician, professor and researcher at NOVA Medical School.
In addition to assessing the platform’s use and integration into clinical practice, the project will make it possible to understand whether this digital dissemination reaches different population groups equitably, seeking to identify potential barriers (particularly in terms of digital literacy) to ensure that it improves access to high-quality information without increasing health inequalities.
DECIDE-SCREEN is an example of how we can bring research, technology, and healthcare closer together to translate scientific evidence into practical solutions with the potential for real-world application.
Federico Guede, researcher at VOH.CoLAB and project coordinator.
The development of the platform builds on research conducted in 2023 by NOVA Medical School researchers Bruno Heleno and Mafalda Proença-Portugal, in collaboration with the NOVA National School of Public Health and the Faculty of Medicine of the University of Porto.
The study, titled General Practitioners’ Perceptions of Decision Aids in Healthcare: A Qualitative Study in Portugal, revealed limited awareness of these tools among most of the physicians interviewed, who often confused them with clinical decision support systems such as risk calculators. More than 90% of participants acknowledged having no training in shared decision-making and not using these tools regularly. Nevertheless, all of them expressed a positive attitude toward their adoption.
The main barriers identified include lack of time during appointments, insufficient funding, and a lack of tools adapted to the Portuguese healthcare context. As possible solutions, the researchers pointed to integrating these tools into health information systems, training healthcare professionals, and translating and culturally adapting existing tools. The findings highlight the need to create conditions that allow for these solutions to be used easily and routinely in primary care.
During medical appointments, there is not always enough time to explain all the available options, answer questions and understand each patient’s preferences. A tool that helps prepare for that conversation could contribute to more informed and shared decisions. Testing it in a clinical setting will be essential to understanding how this approach can be integrated into primary care.
Ana Rita Maria, family physician at the Western Lisbon Local Health Unit, and professor at NOVA Medical School.
The results of DECIDE-SCREEN could contribute to the broader adoption of patient decision aids in the Portuguese National Health Service (SNS), promoting a more empathetic, patient-centered clinical practice that supports more informed and transparent decisions aligned with each individual’s values, while contributing to improvements in the overall quality of care.
