Does Patient Preference Measurement in Decision Aids Improve Decisional Conflict? A Randomized Trial in Men with Prostate Cancer

Shirk, Joseph; Crespi, Catherine M.; Saucedo, Josemanuel; Lambrechts, Sylvia; Dahan, Ely; Kaplan, Robert; Saigal, Christopher S.

doi:10.1007/s40271-017-0255-7

Cited by 26 publications

(17 citation statements)

References 48 publications

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“…Prior efforts to identify factors associated with treatment choice using data limited to patient demographics and tumor characteristics (fixed factors) have struggled to adequately explain patient decision making ( 15 ). Prior studies investigating patient treatment preferences have suggested that incorporating patient preferences for values and goals ( 16 , 17 ) and shared decision making ( 18 , 19 ) may help guide patient treatment choices. The current study confirms that patient-reported decision factors substantially improve the ability to discriminate between those making and those not making aggressive treatment choice for a low-risk disease.…”

Section: Discussionmentioning

confidence: 99%

Patient Decision-Making Factors in Aggressive Treatment of Low-Risk Prostate Cancer

Basak

Usinger

Chen

2022

JNCI Cancer Spectrum

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Background Active surveillance (AS) is under-utilized for low-risk prostate cancer. This study examines decision-making factors associated with AS vs aggressive treatment in a population-based cohort of low-risk patients. Methods Newly-diagnosed patients were enrolled through the North Carolina Central Cancer Registry from 2011–2013 (n = 599), and surveyed regarding 5 factors which may impact treatment decision-making: perceived cancer aggressiveness, aggressiveness of treatment intent, most important goal (eg, cure, quality of life), primary information source, and primary decision-maker. We examined the association between treatment decision-making factors with patient choice for AS vs aggressive treatment using multivariale logistic regression analysis. Results This is a sociodemographically diverse cohort reflective of the population-based design, with 37.6% overall (47.6% among very low-risk patients) choosing AS. Aggressive treatment intent (odds ratio [OR] = 7.09, 95% confidence interval [CI] = 4.57–11.01), perceived cancer aggressiveness (OR = 4.93, 95% CI = 2.71–8.97), most important goal (cure vs other, OR = 1.72, 95% CI = 1.12–2.63) and primary information source (personal/family vs physician, OR = 1.76, 95% CI = 1.10–2.82) were associated with aggressive treatment. Overall, 88.4% of patients (92.2% among very low-risk) who indicated an intent to treat the cancer “not very aggressively” chose AS. Conclusions These data from the patient’s perspective shed new light on potentially modifiable factors that can help further increase AS uptake among low-risk patients. Helping more low-risk patients feel comfortable with a “not very aggressive” treatment approach may be especially important, which can be facilitated throughpatient education interventions to improveunderstanding of the cancer diagnosis and AS having a curative intent.

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Section: Discussionmentioning

confidence: 99%

Patient Decision-Making Factors in Aggressive Treatment of Low-Risk Prostate Cancer

Basak

Usinger

Chen

2022

JNCI Cancer Spectrum

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“…Understanding what factors influence preference is important in the context of assisting patients make appropriate decisions with regards to their treatment. In a randomized controlled trial comparing standard patient education with or without preference measurement in 122 men with prostate cancer, those patients who underwent preference assessment were more certain about their treatment decisions and reported decreased levels of decisional conflict [37]. Similar benefits of shared decision-making have been reported for lung cancer [38] and breast cancer [39].…”

Section: Discussionmentioning

confidence: 90%

Factors that shape preference for acupuncture or cognitive behavioral therapy for the treatment of insomnia in cancer patients

Garland

Eriksen

Song

et al. 2018

Support Care Cancer

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“…Preference assessment may also improve medical decision making 11,27,28 . In the absence of preference assessment of patients, physicians may substitute their own preferences or beliefs about the patient’s preferences, which can lead to suboptimal treatment decisions 29 , 30 .…”

Section: Why Are Patient Preferences Important?mentioning

confidence: 99%

Evidence‐Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences

Naunheim

Randolph

Shin

2020

Otolaryngol.--head neck surg.

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Objective To provide a contemporary resource to update clinicians and researchers on the current state of assessment of patient preferences. Data Sources Published studies and literature regarding patient preferences, evidence-based practice, and patient-centered management in otolaryngology. Review Methods Patients make choices based on both physician input and their own preferences. These preferences are informed by personal values and attitudes, and they ideally result from a deliberative evaluation of the risks, benefits, and other outcomes pertaining to medical care. To date, rigorous evaluation of patient preferences for otolaryngologic conditions has not been integrated into clinical practice or research. This installment of the “Evidence-Based Medicine in Otolaryngology” series focuses on formal assessment of patient preferences and the optimal methods to determine them. Conclusions Methods have been developed to optimize our understanding of patient preferences. Implications for Practice Understanding these patient preferences may help promote an evidence-based approach to the care of individual patients.

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Does Patient Preference Measurement in Decision Aids Improve Decisional Conflict? A Randomized Trial in Men with Prostate Cancer

Abstract: Individual-level preference assessment is feasible in the clinic setting. Patients with prostate cancer who undergo preference assessment are more certain about their treatment decisions and report decreased levels of decisional conflict when making these decisions.

Cited by 26 publications

References 48 publications

Patient Decision-Making Factors in Aggressive Treatment of Low-Risk Prostate Cancer

Patient Decision-Making Factors in Aggressive Treatment of Low-Risk Prostate Cancer

Factors that shape preference for acupuncture or cognitive behavioral therapy for the treatment of insomnia in cancer patients

Evidence‐Based Medicine in Otolaryngology Part XII: Assessing Patient Preferences

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