Development and Validation of a Patient Decision Aid for Prostate Cancer Therapy: from Paternalistic Towards Participative Shared Decision Making

Overview

Journal BMC Med Inform Decis Mak

Publisher Biomed Central

Specialty Medical Informatics

Date 2019 Jul 13

PMID 31296199

Citations 20

Authors

Anshu Ankolekar

Ben G L Vanneste

Esther Bloemen-van Gurp

Joep G van Roermund

Evert J Van Limbergen

Kees van de Beek

Tom Marcelissen

Victor Zambon

Matthias Oelke

Andre Dekker

Cheryl Roumen

Philippe Lambin

Adriana Berlanga

Rianne Fijten

Affiliations

Soon will be listed here.

Abstract

Background: Patient decision aids (PDAs) can support the treatment decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision-making (SDM) approach making participatory medicine possible. The aim of this study was to develop a PDA for prostate cancer that is accurate and user-friendly.

Methods: We followed a user-centered design process consisting of five rounds of semi-structured interviews and usability surveys with topics such as informational/decisional needs of users and requirements for PDAs. Our user-base consisted of 8 urologists, 4 radiation oncologists, 2 oncology nurses, 8 general practitioners, 19 former prostate cancer patients, 4 usability experts and 11 healthy volunteers.

Results: Informational needs for patients centered on three key factors: treatment experience, post-treatment quality of life, and the impact of side effects. Patients and clinicians valued a PDA that presents balanced information on these factors through simple understandable language and visual aids. Usability questionnaires revealed that patients were more satisfied overall with the PDA than clinicians; however, both groups had concerns that the PDA might lengthen consultation times (42 and 41%, respectively). The PDA is accessible on http://beslissamen.nl/ .

Conclusions: User-centered design provided valuable insights into PDA requirements but challenges in integrating diverse perspectives as clinicians focus on clinical outcomes while patients also consider quality of life. Nevertheless, it is crucial to involve a broad base of clinical users in order to better understand the decision-making process and to develop a PDA that is accurate, usable, and acceptable.

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