Evaluating a Decision Aid for Improving Decision Making in Patients with Early-stage Breast Cancer

Patient. 2016 Apr;9(2):161-9. doi: 10.1007/s40271-015-0135-y.

Abstract

Background: Early-stage breast cancer patients face a series of complex treatment decisions, with the first typically being choice of locoregional treatment. There is a need for tools to support patients in this decision-making process.

Methods: We developed an innovative, online locoregional treatment tool based on International Patient Decision Aids Standards criteria. We evaluated its impact on patient knowledge about treatment and appraisal of decision making in a pilot study using a clinical sample of newly diagnosed, breast cancer patients who were randomized to view the decision aid website first or complete a survey prior to viewing the decision aid. Differences in knowledge and decision appraisal between the two groups were compared using t-tests and chi-square tests. Computer-generated preferences for treatment were compared with patients' stated preferences using chi-square tests.

Results: One hundred and one newly diagnosed patients were randomized to view the website first or take a survey first. Women who viewed the website first had slightly higher, though not significantly, knowledge about surgery (p = 0.29) and reconstruction (p = 0.10) than the survey-first group. Those who viewed the website first also appraised their decision process significantly more favorably than did those who took the survey first (p < 0.05 for most decision outcomes). There was very good concordance between computer-suggested and stated treatment preferences.

Conclusion: This pilot study suggests that an interactive decision tool shows promise for supporting early-stage breast cancer patients with complicated treatment decision making.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / surgery
  • Decision Making
  • Decision Support Techniques*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mammaplasty / psychology
  • Mammaplasty / statistics & numerical data
  • Mastectomy / classification
  • Mastectomy / methods
  • Mastectomy / psychology*
  • Mastectomy, Segmental / psychology
  • Mastectomy, Segmental / statistics & numerical data
  • Middle Aged
  • Patient Education as Topic / methods
  • Patient Participation
  • Patient Preference / psychology*
  • Patient Preference / statistics & numerical data