title: A visual approach to providing prognostic information to parents of children with retinoblastoma.
abstract: OBJECTIVE
  Parents must rapidly assimilate complex information when a child is diagnosed with cancer. Education correlates with the ability to process and use medical information. Graphic tools aid reasoning and communicate complex ideas with precision and efficiency.
  
  
  METHODS
  We developed a graphic tool, DePICT (Disease-specific electronic Patient Illustrated Clinical Timeline), to visually display entire retinoblastoma treatment courses from real-time clinical data. We report retrospective evaluation of the effectiveness of DePICT to communicate risk and complexity of treatment to parents. We assembled DePICT graphics from multiple children on cards representing each stage of intraocular retinoblastoma. Forty-four parents completed a 14-item questionnaire to evaluate the understanding of retinoblastoma treatment and outcomes acquired from DePICT.
  
  
  RESULTS
  As a proposed tool for informed consent, DePICT effectively communicated knowledge of complex medical treatment and risks, regardless of the education level. We identified multiple potential factors affecting parent comprehension of treatment complexity and risk. These include language proficiency (p=0.005) and age-related experience, as younger parents had higher education (p=0.021) but lower comprehension scores (p=0.011), regardless of first language.
  
  
  CONCLUSIONS
  Provision of information at diagnosis concerning long-term treatment complexity helps parents of children with cancer. DePICT effectively transfers knowledge of treatments, risks, and prognosis in a manner that offsets parental educational disadvantages.
authors.affiliation: Department of Ophthalmology, Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Panton
authors.forename: Robert
authors.initials: R
authors.lastname: Downie
authors.forename: Tran
authors.initials: T
authors.lastname: Truong
authors.forename: Leslie
authors.initials: L
authors.lastname: Mackeen
authors.forename: Stefane
authors.initials: S
authors.lastname: Kabene
authors.forename: Qi-Long
authors.initials: QL
authors.lastname: Yi
authors.forename: Helen S L
authors.initials: HS
authors.lastname: Chan
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Gallie
mesh_terms: D001294:Attitude to Health; D001364:Awareness; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010353:Patient Education as Topic; D011379:Prognosis; D019572:Retinal Neoplasms / Q000601:surgery*; D012175:Retinoblastoma / Q000601:surgery*; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D014796:Visual Perception / Q000502:physiology*