Evaluation of an Internet-Based Disease Trajectory Decision Tool for Prostate Cancer Screening

Abstract

CDM-based for prostate cancer, VAS and TTO ratings were consistent and were concordant with patient preferences for screening; TTO ratings were also concordant with treatment choice. The use of the CDM-based TTO ratings to adjust for quality of life in decision analytic modeling needs to be explored.

What is lacking in current decision aids on cancer screening?

“…Nine decision aids led to increased intention to get screened; seven of these were on colorectal cancer screening [34, 38, 46, 48, 50, 52, 54], and one each was on cervical cancer screening [13] and prostate cancer screening [86]. Decreased intention to get screened was noted in thirteen decision aids: eight of these were on prostate cancer screening [55–57, 60, 62, 63, 66, 70, 71, 80, 81, 84], two on breast cancer genetic testing [29, 33], and one each on mammogram screening [23], cervical cancer screening [12], and multiple cancer screening [88]. No difference in intention was noted in eighteen decision aids [21, 24–28, 35, 41, 42, 45, 47, 65, 67, 68, 72, 76, 82, 83, 87].…”

What should we know about the person behind a TTO?

“…In empirical work, this has mostly been investigated by looking at marital status and its association with TTO scores. The evidence here generally shows no relation with TTO scores (e.g., [20]), but sometimes a positive relation [16]. Krol et al [19] indicate that the two opposite influences may, on average, cancel out.…”

Measuring patient-centered care: An updated systematic review of how studies define and report concordance between patients’ preferences and medical treatments

“…Twenty-six of the 61 studies involved a patient decision aid [16,18,20,22,25,32,33,[47][48][49][50][51][52][53]56,[58][59][60][61]64,66,68,[72][73][74][75]. Four additional studies reported using education materials such as educational sessions or pamphlets but did not refer to them as decision aids [17,43,63,70].…”

“…Thirty of the 61 studies reported assessment of the subjects' knowledge surrounding the decision [16,18,20,22,25,32,33,44,[47][48][49]51,53,[56][57][58][59][60][61][64][65][66]68,[71][72][73][74][75]77,78]. The majority of these studies (n = 27) used decision-specific items, while three [71,77,78] used generic measurements, e.g.…”