Physicians' opinions about decision aids for patients considering systemic adjuvant therapy for axillary-node negative breast cancer.
OBJECTIVE
To examine variations in physicians' opinions about the appropriateness and content of decision aids for women with breast cancer and criteria for their evaluation.


METHODS
Cross-sectional survey of all 144 Ontario oncologists by Dillman's mailed survey design. The response rate was 87%.


RESULTS
The predominant current practice pattern was to spontaneously inform patients about the treatment recommendations, degree of certainty regarding the recommendations, treatment regime, benefits and side effects. Most respondents (94%) endorsed patient decision aids, particularly when there was high uncertainty about providing adjuvant treatment. Over three-quarters endorsed measuring the following outcomes of decision aids: patients' clarity of trade-offs involved (e.g. survival vs. side effects); comprehension of treatment alternatives, risks and benefits; accuracy of expectations; decision satisfaction; anxiety; commitment to the decision; length of time to complete the decision aid; and decision uncertainty. The least support was for the use of the decision itself as an outcome measure.


CONCLUSIONS
There is considerable consensus regarding the indications for, content and criteria for evaluating decision aids which should be considered when developing aids relevant to the needs of clinicians and patients.
O'Connor
A M
AM
Clinical Epidemiology Unit, Ottawa Civic Hospital, Ontario, Canada.
Llewellyn-Thomas
H A
HA
Sawka
C
C
Pinfold
S P
SP
To
T
T
Harrison
D E
DE
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001365:Axilla; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires