Decision Aid to Technologically Enhance Shared decision making (DATES): study protocol for a randomized controlled trial

Jimbo, Masahito; Kelly‐Blake, Karen; Sen, Ananda; Hawley, Sarah T.

doi:10.1186/1745-6215-14-381

Cited by 11 publications

(4 citation statements)

References 67 publications

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“…Studies have often demonstrated the positive effects of Web-based decision-making tools [25]. Considering this, our research is aimed to more closely identify with and assure patients during the dynamic relationship that is patient-doctor communications.…”

Section: Discussionmentioning

confidence: 99%

Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach

Hung¹,

Wu²,

Liang

et al. 2019

J Med Internet Res

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Background Patients with early-stage breast cancer have numerous options when choosing the type of breast surgery method to be applied. Each of these options lead to a similar long-term survival rate, but result in significant differences in appearance, function, cost, recurrence rate, and various other relevant considerations. However, the time available for detailed communication with each patient is often limited in clinics, which puts these women under great psychological stress and can hinder their surgery-related decision making. Objective The objective of this study was to develop a multipurpose surgery decision-making website providing medical information, psychological support, and decision-related simulation for women during breast cancer surgery-related decision making. Methods Using the 4 steps of action research, which involve multigroup teamwork via regular team meetings, the following were performed: (1) Planning: searching, analyzing, and evaluating health websites to consensually decide the major infrastructure; (2) Action: work was performed simultaneously in 4 groups, which consisted of medical information collection and editing, patient interviews and data extraction, webpage content design, and programming to create or host the website; (3) Evaluation: the website was tested by clinical experts and focus groups of former breast cancer patients to assess its effectiveness and pinpoint appropriate improvements; and (4) Reflection: constant dialogue was conducted between the various participants at each step, which was used as the foundation and motivation of next plan-action-evaluation-reflection circle. Results Using the action research approach, we completed the development of our website, which includes the following: (1) “Woman’s Voice”—an animated comic depicting the story of a female breast cancer patient with interspersed questions for the users that will help them better empathize with the experience; (2) “Cancer Information Treasure House”—providing breast cancer surgery-related information through text, tables, pictures and a presentation video; (3) “Decision-making Simulator”—helping patients think through and check the pros and cons of the different surgical options via visual-based interactions including “Stairs Climbing” and “Fruit of Hope”; and (4) “Recommended Links”—providing reliable websites for further reference. Additionally, we have further improved the website based on the feedback received from postsurgery breast cancer patients and clinicians. We hope to continue improving to better meet both the patients’ and health providers’ needs and become a practical decision-making aid for patients undergoing breast cancer surgery. Conclusions We have created the first breast cancer surgery decision-making assistance tool in Taiwan using a “Web-based” and multifunctional website design. This site aims to provide health care knowledge, psychological ...

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Section: Discussionmentioning

confidence: 99%

Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach

Hung¹,

Wu²,

Liang

et al. 2019

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Most trials of traditional decision aids demonstrate reduced use of services with marginal benefit and increased use of beneficial services. 23,[49][50][51][52] Although Figure 2 shows decision module users had higher rates of breast and prostate cancer screening, which may not be good for screening services with small or zero net benefit, users self-selected, and module responses indicated a substantial proportion were already inclined to be screened. Randomized controlled trials of similar systems and trials that assess whether decisions better align with values are needed.…”

Section: Discussionmentioning

confidence: 99%

Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case

et al. 2017

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“…Sixth, the issue of tailoring screening according to the patient’s CRC risk (eg, recommending colonoscopy only to those with increased risk vs offering options to those with average risk) was not discussed. Incorporating patients’ CRC risk in CRC screening discussion is important, and our current website (now renamed as ColoDATES and tested in the field in a federally funded study), includes an interactive risk assessment tool [ 47 ]. Seventh, the focus groups were conducted in 2006 and 2007 and therefore do not necessarily reflect the increased use of EHRs observed over the past few years.…”

Section: Discussionmentioning

confidence: 99%

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

et al. 2013

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BackgroundInformation is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening.ObjectiveTo address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow.MethodsFive focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter.ResultsAll physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running.ConclusionsCommunity practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions.

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Decision Aid to Technologically Enhance Shared decision making (DATES): study protocol for a randomized controlled trial

Cited by 11 publications

References 67 publications

Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach

Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach

Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

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