Use and Evaluation of a CD-ROM-Based Decision Aid for Prostate Cancer Treatment Decisions

Abstract

The survival advantages associated with different treatments for localized prostate cancer (PCa) continue to be uncertain. We evaluated patients' use of an interactive CD-ROM-based decision aid designed to improve informed decision making about PCa treatment. Newly diagnosed, early-stage PCa patients who had not made a treatment decision completed a baseline telephone interview (N = 132), were mailed the CD-ROM, and completed a one-month follow-up interview (N = 120; 91%). Compared to non-users (21%), CD-users (79%) preferred to make an independent rather than a shared treatment decision (OR = 3.5, CI 1.2,10.5). The majority of users (63%-90%) responded positively regarding the length and clarity of the information. Further, 76% reported using the CD as much/more than other information sources. A preference for having less decisional control predicted greater satisfaction with the CD (F[7,87] = 4.75, p< .05). Electronic utilization data revealed that the topics most accessed concerned treatment information and that users spent over an hour using the CD (median = 72 minutes). This electronic educational tool was well-accepted by patients and may be particularly useful for patients who desire less control over their treatment decisions and who are less proactive in seeking information on their own.

Decision aids for localized prostate cancer treatment choice: Systematic review and meta‐analysis

“…We excluded one trial in which a substantial proportion of patients did not have localized prostate cancer (34% had “intracapsular” prostate cancer, 46% had “locally advanced” prostate cancer, and 20% had “distant” prostate cancer) . Three studies (21%) confirmed the accuracy of our consensus data extraction, 8 studies (57%) corrected some errors and/or added additional information, and 3 groups (21%) did not respond to our requests . Ten RCTs were conducted in North America, and the remaining studies were conducted in Europe (The Netherlands, Spain, United Kingdom) and Australia (Table ) .…”

“…Screening titles, abstracts, and full texts yielded 14 eligible RCTs (Fig. ) . We excluded one trial in which a substantial proportion of patients did not have localized prostate cancer (34% had “intracapsular” prostate cancer, 46% had “locally advanced” prostate cancer, and 20% had “distant” prostate cancer) .…”

“…Eleven (79%) of the 14 RCTs reported the use of a theoretical framework in the development of their intervention, with the Ottawa Decision Support Framework being the most common (5 of 11 RCTs; 45%) (Table ). Most decision aids (9 of 14 decision aids; 64%) used multiple media to convey information (n = 7) . The types of media used included personal interviews (n = 5), printed material (n = 11), audio recordings (n = 3), videos (n = 4), and interactive computer‐based tools (n = 4) .…”

Decisional outcomes following use of an interactive web-based decision aid for prostate cancer screening

“…A growing number of decision aids are being provided online as adults are using the Internet in greater numbers to access health information [13,14]. Additionally, studies of men with PCa found that the Internet and electronically based information were important sources of information regarding both screening and diagnosis [15][16][17][18]. In general, online health information seekers say they feel more confident in starting a discussion with their doctor than those who do not use the Internet to find health information [19].…”

Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer

“…To help patients with localized prostate cancer make an informed treatment decision, intervention strategies in current decision aids include communication skills training or role modeling to improve communication between patients, their family members, and providers for clinical encounters [14–16]; providing information using multimedia [14,15,17–24]; facilitating value clarification and reducing decision conflicts [14,18,19,22,24]; and providing consultation plans and preparation materials [19,23–25]. Although improving communication skills for patients and their family members is one of the integral strategies in decision aid interventions for localized prostate cancer treatment choices, a recent systematic review and meta -analysis [5] found that patient-provider communication was evaluated only in one clinical trial using a Likert-type scale after consultation visits [16].…”