A usability study of a computerized decision aid to help patients with, early stage papillary thyroid carcinoma in, decision-making on adjuvant radioactive iodine treatment.
OBJECTIVE
We tested the usability of a patient-directed decision aid (DA), intended for patients with early stage papillary thyroid carcinoma (PTC) deciding to accept or reject adjuvant radioactive iodine (RAI) treatment. This decision is complicated by uncertainty of the medical evidence relating to potential treatment benefits.


METHODS
The DA was tested by 12 thyroid cancer survivors, 7 thyroid specialty physicians, and 30 lay individuals with no history of thyroid cancer. The participants completed the System Usability Scale for human-computer interaction questionnaire. The medical knowledge of lay participants was assessed before and after DA exposure. Qualitative participant feedback was obtained by thinking aloud during DA use, as well as from interviews.


RESULTS
Participants generally found the usability of the DA acceptable. The DA significantly increased medical knowledge. In spite of some physicians' concerns about disclosure of treatment controversy and evidence uncertainty, it was found to be acceptable to non-physicians.


CONCLUSIONS
A computerized DA on RAI treatment is acceptable to physicians and non-physicians and can improve medical knowledge.


CONCLUSIONS
In counseling patients about complex medical decisions, disclosure of uncertainty related to medical evidence may be acceptably conveyed using a DA.
Sawka
Anna M
AM
Department of Medicine, University Health Network - Toronto General Hospital, Toronto, Canada. sawkaam@yahoo.com
Straus
Sharon
S
Gafni
Amiram
A
Meiyappan
Soumia
S
O'Brien
Mary Ann
MA
Brierley
James D
JD
Tsang
Richard W
RW
Rotstein
Lorne
L
Thabane
Lehana
L
Rodin
Gary
G
George
Susan R
SR
Goldstein
David P
DP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma; D002291:Carcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy*; D003658:Decision Making, Computer-Assisted; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D018714:Radiotherapy, Adjuvant; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D013965:Thyroidectomy; D055815:Young Adult
D007457:Iodine Radioisotopes