title: Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer.
abstract: BACKGROUND
  A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer.
  
  
  METHODS
  We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265) and to patients with colorectal cancer (n = 102).
  
  
  RESULTS
  Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88%-100%). Patients (79%) chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%). No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant) but without survival benefit.
  
  
  CONCLUSIONS
  Healthy persons' and patients' decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.
authors.affiliation: Department of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hofmann
authors.forename: Janina
authors.initials: J
authors.lastname: Vetter
authors.forename: Christiane
authors.initials: C
authors.lastname: Wachter
authors.forename: Doris
authors.initials: D
authors.lastname: Henne-Bruns
authors.forename: Franz
authors.initials: F
authors.lastname: Porzsolt
authors.forename: Marko
authors.initials: M
authors.lastname: Kornmann
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001296:Audiovisual Aids / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D003657:Decision Making; D004522:Educational Status; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011184:Postoperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016019:Survival Analysis