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Patient decision aids for cancer treatment

Are there any alternatives?

  1. Gillian Spiegle BSc1,2,
  2. Eisar Al-Sukhni MD1,2,3,
  3. Selina Schmocker BSc2,3,
  4. Anna R. Gagliardi PhD1,4,6,
  5. J. Charles Victor MSc1,5,6,
  6. Nancy N. Baxter MD, PhD1,5,6,7,
  7. Erin D. Kennedy MD, PhD1,2,3,6,8,†,*

Article first published online: 18 JUL 2012

DOI: 10.1002/cncr.27641

Issue

Cancer

Cancer

Volume 119, Issue 1, pages 189–200, 1 January 2013

Additional Information

How to Cite

Spiegle, G., Al-Sukhni, E., Schmocker, S., Gagliardi, A. R., Victor, J. C., Baxter, N. N. and Kennedy, E. D. (2013), Patient decision aids for cancer treatment. Cancer, 119: 189–200. doi: 10.1002/cncr.27641

Author Information

  1. 1

    University of Toronto, Toronto, Ontario, Canada

  2. 2

    Division of General Surgery, Mount Sinai Hospital and Samuel Lunenfeld Research Institute, Toronto, Ontario, Canada

  3. 3

    Zane Cohen Centre for Digestive Diseases, Toronto, Ontario, Canada

  4. 4

    Toronto General Hospital and Toronto General Research Institute, Toronto, Ontario, Canada

  5. 5

    Institute of Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada

  6. 6

    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

  7. 7

    Department of Surgery and Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada

  8. 8

    Department of Surgical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada

  1. †

    Fax: (416) 586-5932

*Division of General Surgery, Mount Sinai Hospital, 600 University Avenue, Suite 455, M5G 1X5, Toronto, Canada

  1. †

    Fax: (416) 586-5932

Publication History

  1. Issue published online: 17 DEC 2012
  2. Article first published online: 18 JUL 2012
  3. Manuscript Accepted: 11 APR 2012
  4. Manuscript Revised: 1 MAR 2012
  5. Manuscript Received: 23 DEC 2011

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Keywords:

  • cancer treatment;
  • treatment decision-making;
  • decision support interventions;
  • patient decision aids;
  • implementation

Abstract

BACKGROUND:

Although patient decision aids (pDAs) are effective, widespread use of pDAs for cancer treatment has not been achieved. The objectives of this study were to perform a systematic review to identify alternate types of decision support interventions (DSIs) for cancer treatment and a meta-analysis to compare the effectiveness of these DSIs to pDAs.

METHODS:

The inclusion criteria for the study were: 1) all published studies using a randomized, controlled trial design, and 2) DSIs involving treatment decision-making for breast, prostate, colorectal, and/or lung cancer. For this analysis, DSIs were classified as pDAs if: 1) one reported outcome measure mapped onto the International Patient Decision Aids Standards Collaboration effectiveness criterion, and 2) the DSI was evaluated relative to standard consultation. Random effects models were used to compare the effectiveness of pDAs relative to other identified DSIs for reported outcomes.

RESULTS:

A total of 71 studies were reviewed, and 24 met the inclusion criteria. Overall, there were no significant differences in knowledge, satisfaction, anxiety, or decisional conflict scores between pDAs and other DSIs.

CONCLUSIONS:

This study showed that the effectiveness of other DSIs, including question prompt lists and audiorecording of the consultation, is similar to pDAs. This is important because it may be that these less complex DSIs may be all that is necessary to achieve similar outcomes as pDAs for cancer treatment. Cancer 2013. © 2012 American Cancer Society.

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