title: Personal preferences and discordant prostate cancer treatment choice in an intervention trial of men newly diagnosed with localized prostate cancer.
abstract: BACKGROUND
  Men diagnosed with localized prostate cancer (LPC) can choose from multiple treatment regimens and are faced with a decision in which medical factors and personal preferences are important. The Personal Patient Profile-Prostate (P3P) is a computerized decision aid for men with LPC that focuses on personal preferences. We determined whether the P3P intervention improved the concordance of treatment choice with self-reported influential side-effects compared with a control group.
  
  
  METHODS
  English/Spanish-speaking men diagnosed with LPC (2007-2009) from four US cities were enrolled into a randomized trial and followed through 6-months via mailed or online questionnaire. Men were randomized to receive the P3P intervention or standard education plus links to reputable websites. We classified choice as concordant if men were concerned with (a) sexual function and chose external beam radiotherapy or brachytherapy, (b) bowel function and chose prostatectomy, (c) sex, bowel, and/or bladder function and chose active surveillance, or (d) not concerned with any side effect and chose any treatment. Using logistic regression, we calculated odds ratios (OR) and 95% confidence intervals (CI) for the association between the P3P intervention and concordance.
  
  
  RESULTS
  Of 448 men, most were <65 years, non-Hispanic white, had multiple physician consultations prior to enrollment, and chose a treatment discordant with concerns about potential side effects. There was no significant difference in concordance between the intervention (45%) and control (50%) group (OR = 0.82; 95%CI = 0.56, 1.2).
  
  
  CONCLUSIONS
  The P3P intervention did not improve concordance between potential side effects and treatment choice. Information and/or physician consultation immediately after diagnosis was likely to influence decisions despite concerns about side effects. The intervention may be more effective before the first treatment options consultation.
  
  
  BACKGROUND
  NCT00692653 http://clinicaltrials.gov/ct2/show/NCT00692653.
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, LW 519, Boston, MA 02215, USA. Jaclyn_Bosco@dfci.harvard.edu
authors.forename: Jaclyn L F
authors.initials: JL
authors.lastname: Bosco
authors.forename: Barbara
authors.initials: B
authors.lastname: Halpenny
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
mesh_terms: D002755:Choice Behavior; D035061:Control Groups; D020000:Decision Support Systems, Clinical; D005242:Fecal Incontinence / Q000150:complications; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D057240:Patient Preference / Q000523:psychology* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000150:complications; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014550:Urinary Incontinence, Stress / Q000150:complications; D014584:User-Computer Interface