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Grabbe P, Gschwendtner KM, Maatouk I, Strobel SB, Salzmann M, Bossert J, Eich W, Wild B, Meier F, Hassel JC, Bieber C. Development and validation of a web-based patient decision aid for immunotherapy for patients with metastatic melanoma: study protocol for a multicenter randomized trial. Trials 2021; 22:294. [PMID: 33879219 PMCID: PMC8056554 DOI: 10.1186/s13063-021-05234-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/29/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Patients with metastatic melanoma and their physicians are confronted with a complex decision regarding first-line therapy. Risks and benefits vary considerably between various treatment options. With this in mind, we aim to develop and evaluate a patient decision aid (PtDA) to inform patients about the risks and benefits of treatment options, namely, immunotherapy as monotherapy, immunotherapy as combination therapy, and treatment with BRAF/MEK inhibitors. We aim to test whether the use of this PtDA before medical consultation will increase patients' knowledge of treatment options and thus promote shared decision-making (SDM) and patient decision satisfaction. METHODS In total, 128 patients with metastatic melanoma from two German cancer centers will be randomized to the intervention group (IG), receiving access to the PtDA before medical consultation, or the control group (CG), receiving treatment as usual (TAU), i.e., medical consultation alone. There will be three major assessment points (before intervention, T0; after intervention, T1; and 3 months after intervention, T2). The main outcome is the patient's knowledge of their treatment options, measured by a self-developed, piloted multiple-choice test at T1. Secondary outcome measures will include the extent of SDM during medical consultation, assessed by Observer OPTION 5, and patient decision satisfaction, assessed by the Satisfaction with Decision Scale (SwD), at T1 and T2. DISCUSSION This trial will assess the effectiveness of a developed PtDA to enhance patient knowledge of treatment options for metastatic melanoma, SDM, and patient decision satisfaction. If the efficacy can be proven, the PtDA will be implemented nationwide in Germany to close a relevant gap in the education and care of patients with metastatic melanoma. TRIAL REGISTRATION ClinicalTrials.gov NCT04240717 . Registered on 27 January 2020.
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Affiliation(s)
- Pia Grabbe
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Kathrin M. Gschwendtner
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Sophia B. Strobel
- National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Martin Salzmann
- National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Julia Bossert
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Köln, Germany
- TAKEPART Media + Science, Köln, Germany
| | - Wolfgang Eich
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Friedegund Meier
- National Center for Tumor Diseases, University Hospital Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Jessica C. Hassel
- National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Christiane Bieber
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Thibautstraße 4, 69115 Heidelberg, Germany
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Moolla Y, Adam A, Perera M, Lawrentschuk N. 'Prostate Cancer' Information on the Internet: Fact or Fiction? Curr Urol 2020; 13:200-208. [PMID: 31998052 DOI: 10.1159/000499271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background/Aims In today's information era, patients often seek information regarding health using the internet. We assessed reliability and validity of internet information regarding 'prostate cancer'. Methods Search term 'prostate cancer' used on Google website (June 2017). Critical analysis was performed on first 100 hits using JAMA benchmarks, DISCERN score, Health on the Net. Results 33 500 000 hits returned. Top 100 hits were critically analyzed. Ten links [duplicate links (n = 7), book reviews (n = 1), dead sites (n = 2)] were excluded, therefore 90 were analyzed. Subcategories assessed included: commercial (53.33%), university/medical center (24.44%), government (13.33%); non-governmental/ non-profit organizations (8.89%). Sub-type of information content assessed included: factual (74.44%), clinical trials (18.89%); stories (5.56%); question and answer (1.11%). Website rated as HONcode seal positive (14,44%) or seal negative (85,56%). Website content based on JAMA benchmarks: 0 benchmarks (4.44%), 1 benchmark (16.67%), 2 benchmarks (34.44%), 3 benchmarks (27.78%), 4 benchmarks (16.67%). DISCERN score rated: 'low' score (16-32) = 12 websites (13.33%), 'moderate' score (33-64 points) = 68 websites (75.56%), 'high' score (≥ 65 points) = 10 websites (11.11%). Conclusion Critical assessment of 'Prostate Cancer' information on the internet, showed that overall quality was observed to be accurate, however majority of individual websites are unreliable as a source of information by itself for patients. Doctors and patients need to be aware of this 'quality vs quantity' discrepancy when sourcing PCa information on the internet.
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Affiliation(s)
- Yusuf Moolla
- Department of Oncology, Klerksdorp Hospital, Klerksdorp/Tshepong Hospital Complex, Klerksdorp, North West Province
| | - Ahmed Adam
- Department of Urology, Helen Joseph Hospital & Department of Paediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, Division of Urology, Department of Surgery, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Marlon Perera
- Department of Surgery, Austin Health, University of Melbourne, VIC and Department of Surgery, University of Queensland, Brisbane, QLD
| | - Nathan Lawrentschuk
- Department of Surgery, Austin Health, University of Melbourne, and Olivia-Newton John Cancer Centre, University of Melbourne, and Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Vromans RD, van Eenbergen MC, Pauws SC, Geleijnse G, van der Poel HG, van de Poll-Franse LV, Krahmer EJ. Communicative aspects of decision aids for localized prostate cancer treatment - A systematic review. Urol Oncol 2019; 37:409-429. [PMID: 31053529 DOI: 10.1016/j.urolonc.2019.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/29/2019] [Accepted: 04/08/2019] [Indexed: 11/17/2022]
Abstract
CONTEXT Despite increasing interest in the development and use of decision aids (DAs) for patients with localized prostate cancer (LPC), little attention has been paid to communicative aspects (CAs) of such tools. OBJECTIVE To identify DAs for LPC treatment, and review these tools for various CAs. MATERIALS AND METHODS DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO; 1990-2018) and online sources, in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Identified DAs were reviewed for the International Patient Decision Aid Standards criteria, and analyzed on CAs, including information presentation, personalization, interaction, information control, accessibility, suitability, and source of information. Nineteen DAs were identified. RESULTS International Patient Decision Aid Standards scores varied greatly among DAs. Crucially, substantial variations in use of CAs by DAs were identified: (1) few DAs used visual aids to communicate statistical information, (2) none were personalized in terms of outcome probabilities or mode of communication, (3) a minority used interactive methods to elicit patients' values and preferences, (4) most included biased cross tables to compare treatment options, and (5) issues were observed in suitability and accessibility that could hinder implementation in clinical practice. CONCLUSIONS Our review suggests that DAs for LPC treatment could be further improved by adding CAs such as personalized outcome predictions and interaction methods to the DAs. Clinicians who are using or developing such tools might therefore consider these CAs in order to enhance patient participation in treatment decision-making.
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Affiliation(s)
- Ruben D Vromans
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands; Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands.
| | - Mies C van Eenbergen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Steffen C Pauws
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands; Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands; Chronic Disease Management, Philips Research, Eindhoven, the Netherlands
| | - Gijs Geleijnse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Emiel J Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands; Tilburg Center for Cognition and Communication, Tilburg University, Tilburg, the Netherlands
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Laviana AA, Pannell SC, Huen KHY, Bergman J. Engaging patients in complex clinical decision-making: Successes, pitfalls, and future directions. Urol Oncol 2017; 35:569-573. [PMID: 28789928 DOI: 10.1016/j.urolonc.2017.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/05/2017] [Accepted: 07/12/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects. The same applies to renal cancer where patient have to sift through information to decide among active surveillance, partial nephrectomy, racial nephrectomy, robotic vs. open surgery, and ablation. BASIC PROCEDURES Ultimately, patient, providers, and stakeholders lack high-quality evidence to effectively guide treatment decisions, and these decisions become even harder to discern when considering end-of-life care, palliative care, and the ethics regarding the new End of Life Option Act. As of November 1, 2016, the number of open urologic cancer clinical trials listed on ClinicalTrials.gov was 843. MAIN FINDINGS Although we continue to make tremendous strides in urologic cancer care, our options for choosing the best treatment from a patient and provider standpoint are seemingly growing murkier. We need to continue to understand how health-related quality of life varies from patient to patient, and ultimately, incorporate patient preferences and values into the treatment decision in order to make high-quality treatment decisions. CONCLUSIONS The remained of this articles will focus on the significant strides made in urologic oncology regarding these difficult decisions from localized disease to end-of-life care and also will detail what needs to be done as we continue to pivot forward.
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Affiliation(s)
- Aaron A Laviana
- Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine at University of California, Los Angeles, CA.
| | - Stephanie C Pannell
- Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine at University of California, Los Angeles, CA
| | - Kathy H Y Huen
- Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine at University of California, Los Angeles, CA
| | - Jonathan Bergman
- Department of Family Medicine, David Geffern School of Medicine at UCLA, Los Angeles, CA; Veterans Health Affairs-Greater Los Angeles, Los Angeles, CA; Department of Urology, Olive View-UCLA Medical Center, Sylmar, CA
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Engelen A, Vanderhaegen J, Van Poppel H, Van Audenhove C. The use of decision aids on early detection of prostate cancer: views of men and general practitioners. Health Expect 2017; 20:221-231. [PMID: 26890150 PMCID: PMC5354056 DOI: 10.1111/hex.12451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVE While decision support tools such as decision aids can contribute to shared decision making, implementing these tools in daily practice is challenging. To identify and address issues around the use of decision support tools in routine care, this study explores the views of men and general practitioners on using a DA for early detection of prostate cancer. METHODS, SETTING AND PARTICIPANTS Group discussions and semi-structured interviews were carried out with 43 men and 16 general practitioners familiar with a previously developed decision aid. Data were analysed using qualitative description. RESULTS Views on using the decision support tool could be classified into four categories: no need for decision making, need for support, perceived benefit and practical barriers. For each category, several underlying themes could be identified that reflect the absence or presence of prerequisites to successful decision support delivery. DISCUSSION AND CONCLUSION While men and general practitioners generally have positive attitudes to shared decision making, for both parties attitudes such as not agreeing that there is a decision to be made and doubts on the beneficence of using DAs were identified as factors that may hinder the use of a DA in clinical practice. Participants formulated strategies to support the use of DAs, mainly supplementing DAs with short tools and investing in both training programmes and large-scale awareness raising of the general public.
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Al-Itejawi HHM, van Uden-Kraan CF, Vis AN, Nieuwenhuijzen JA, Hofstee MJA, van Moorselaar RJA, Verdonck-de Leeuw IM. Development of a patient decision aid for the treatment of localised prostate cancer: a participatory design approach. J Clin Nurs 2016; 25:1131-44. [DOI: 10.1111/jocn.13120] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2015] [Indexed: 01/09/2023]
Affiliation(s)
- Hoda HM Al-Itejawi
- Department of Urology; VU University Medical Center; Amsterdam The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
| | - André N Vis
- Department of Urology; VU University Medical Center; Amsterdam The Netherlands
| | | | - Myrna JA Hofstee
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
| | | | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
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Troost EG, Wink KC, Zindler JD, De Ruysscher D. Management of early stage lung cancer: a radiation oncologist's perspective. Lung Cancer 2015. [DOI: 10.1183/2312508x.10010214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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