Decision Support with the Personal Patient Profile-Prostate: A Multicenter Randomized Trial

Berry, Donna L.; Hong, Fangxin; Blonquist, Traci M.; Halpenny, Barbara; Filson, Christopher P.; Master, Viraj A.; Sanda, Martin G.; Chang, Peter; Chien, Gary W.; Jones, Randy; Krupski, Tracey L.; Wolpin, Seth; Wilson, Leslie; Hayes, Julia H.; Trinh, Quoc Dien; Sokoloff, Mitchell; Somayaji, Prabhakara

doi:10.1016/j.juro.2017.07.076

Cited by 38 publications

(68 citation statements)

References 26 publications

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“…Baseline and clinical characteristics of the 392 men who participated in P3P-II [33] are provided in Table 1. A total of 365 cases had complete DCS data and were used in the following analysis.…”

Section: Resultsmentioning

confidence: 99%

“…We conducted a secondary analysis of data from two multi-site trials that tested the Personal Patient Profile-Prostate (P3P), a tailored decision aid for men with localized prostate cancer (LPC). The details of these trials, herein referred to as P3P-I and P3P-II, have been reported elsewhere [32, 33]. Briefly, in P3P-I, baseline decisional conflict was measured using the original DCS among men with LPC who were candidates for at least two treatment options and who had not yet begun therapy [32].…”

Section: Methodsmentioning

confidence: 99%

“…The study was approved by the Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Review Board and the review board at each site. In P3P-II, baseline decisional conflict was measured using the low literacy DCS among men with LPC who had had no more than one consultation visit, had not made a final care decision, and had not begun active surveillance or received any prostate cancer treatment [33]. The study was approved by the Dana-Farber/Harvard Cancer Center institutional review board and the review board at each site.…”

Section: Methodsmentioning

confidence: 99%

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Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer

Pozzar

Berry

Hong

2019

BMC Med Inform Decis Mak

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Background Decisional conflict is associated with decision quality and may affect decision outcomes. In the health sciences literature, the Decisional Conflict Scale is widely used to measure decisional conflict, yet limited research has described the psychometric properties of the Decisional Conflict Scale subscales and of the low literacy version of the scale. The purpose of this secondary data analysis was therefore to examine properties of the original (DCS-12) and low literacy (LL DCS-10) Decisional Conflict Scales using Classical Measurement Theory and Item Response Theory. Methods Data from two multi-site trials of men with prostate cancer were used to analyze the DCS-12, LL DCS-10, and an aggregated DCS-12 dataset in which five response options were aggregated into three. Internal consistency was estimated with Cronbach’s alphas. Subscale correlations were evaluated with Pearson’s correlation coefficient. Item difficulty, item discrimination, and test information were evaluated using Graded Response Modeling (GRM). The likelihood ratio test guided model selection. Results Cronbach’s alphas for the total scales and three of four subscales were ≥ 0.85. Alphas ranged from 0.34–0.57 for the support subscales. Subscale correlations ranged from 0.42–0.71 ( P < 0.001). Items on the DCS-12 exhibited the widest range of difficulty. Two items on the support subscale had low to moderate discrimination and contributed little information. Only the DCS-12 was informative across the full range of decisional conflict values. Conclusions Lack of precision in the support subscale raises concerns about subscale validity. The DCS-12 is most capable of discriminating between respondents with high and low decisional conflict. Evaluation of interventions to reduce decisional conflict must consider the above findings. Electronic supplementary material The online version of this article (10.1186/s12911-019-0853-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer

Pozzar

Berry

Hong

2019

BMC Med Inform Decis Mak

Self Cite

View full text Add to dashboard Cite

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“…Schaffert et al [16] developed an online tutorial to assist and prepare patients in treatment decision-making. A similar approach utilised the Personal Patient Profile—Prostate (P3P) in a multicentre randomised trial [17] . When compared with “usual care”, the P3P intervention was associated with less decision conflict.…”

Section: Evidence Synthesismentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future

et al. 2020

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Context The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward. Objective To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic. Evidence acquisition A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families. Evidence synthesis Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients’ mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement. Conclusions The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care. Patient summary The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.

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“…Schaffert et al introduced an online tutorial for decision-making and communication with cancer patients, which was tested in a pilot study afterwards [35]. This approach was also evaluated by the Personal Patient Profile-Prostate (P3P) in a multicentre randomised trial and gave promising results as it significantly decreased decisional conflict in comparison to "usual care" [36]. Moreover, no significant difference has been found between nurse-led and standard follow-up visits satisfaction among patients after radiotherapy [37].…”

Section: Follow-upmentioning

confidence: 99%

Changes in management of patients with cancer during COVID-19 pandemic

Kosz

Zarankiewicz

Zielińska

et al. 2020

J Educ Health Sport

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Introduction: As of March 11, 2020, COVID-19 has been declared as a global pandemic. It has spread rapidly and profoundly impact the function of health care system all around the world. As a result, management and organisation of oncology units had to be altered in order to provide security measures and safe care for patients. Purpose: The aim of this paper is to review current knowledge involving management of patients with malignancies during COVID-19 pandemic. Particular attention has been paid to changes in diagnosis, treatment and follow-up of patients with cancer. Material and methods: The review includes publications released in 2019 and 2020. The data has been collected by the use of PubMed, WHO website and other online published guidance. Results: As a lot of clinical trials has been suspended, current therapy options for patients with cancer has been also limited. Moreover, patients became fearful of becoming infected by SARS-CoV-2 and accordingly they were less likely to attend screening programmes. Additionally, as the amount of surgeries has been reduced, the need for radiotherapy service has increased. Chemotherapy has been found to be risky for patients with cancer as it may favour them to SARS-CoV-2 infection. Conclusions: Appropriate security measures need to be implemented in order to protect against SARS-CoV-2 infection but optimal health care access should be provided as well. There is a high necessity to share knowledge and experience on the impact of pandemic on patients with malignancies. However, a lot of patients are fearful of COVID-19, adverse effects of delayed diagnosis, treatment and follow-up should not be diminished.

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Decision Support with the Personal Patient Profile-Prostate: A Multicenter Randomized Trial

Cited by 38 publications

References 26 publications

Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer

Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer

The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future

Changes in management of patients with cancer during COVID-19 pandemic

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