title: Systematic Review of Decision Aids for Newly Diagnosed Patients with Prostate Cancer Making Treatment Decisions.
abstract: OBJECTIVE
  Despite established evidence for using patient decision aids, use with newly diagnosed patients with prostate cancer remains limited partly due to variability in aid characteristics. We systematically reviewed decision aids for newly diagnosed patients with prostate cancer.
  
  
  METHODS
  Published peer reviewed journal articles, unpublished literature on the Internet and the Ottawa decision aids web repository were searched to identify decision aids designed for patients with prostate cancer facing treatment decisions. A total of 14 aids were included in study. Supplementary materials on aid development and published studies evaluating the aids were also included. We studied aids designed to help patients make specific choices among options and outcomes relevant to health status that were specific to prostate cancer treatment and in English only. Aids were reviewed for IPDAS (International Patient Decision Aid Standards) and additional standards deemed relevant to prostate cancer treatment decisions. They were also reviewed for novel criteria on the potential for implementation. Acceptable interrater reliability was achieved at Krippendorff α = 0.82.
  
  
  RESULTS
  Eight of the 14 decision aids (57.1%) were developed in the United States, 6 (42.8%) were print based, 5 (35.7%) were web or print based and only 4 (28.5%) had been updated since 2013. Ten aids (71.4%) were targeted to prostate cancer stage. All discussed radiation and surgery, 10 (71.4%) discussed active surveillance and/or watchful waiting and 8 (57.1%) discussed hormonal therapy. Of the aids 64.2% presented balanced perspectives on treatment benefits and risks, and/or outcome probabilities associated with each option. Ten aids (71.4%) presented value clarification prompts for patients and steps to make treatment decisions. No aid was tested with physicians and only 4 (28.6%) were tested with patients. Nine aids (64.2%) provided details on data appraisal and 4 (28.6%) commented on the quality of evidence used. Seven of the 8 web or computer based aids (87.5%) provided patients with the opportunity to interact with the aid. All except 1 aid scored above the 9th grade reading level. No evidence on aid implementation in routine practice was available.
  
  
  CONCLUSIONS
  As physicians look to adopt decision aids in practice, they may base the choice of aid on characteristics that correlate with patient socioeconomic and educational status, personal practice style and practice setting.
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri. Electronic address: padsul@slu.edu.
authors.forename: Prajakta
authors.initials: P
authors.lastname: Adsul
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Wray
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri.
authors.forename: Kyle
authors.initials: K
authors.lastname: Spradling
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri.
authors.forename: Oussama
authors.initials: O
authors.lastname: Darwish
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri.
authors.forename: Nancy
authors.initials: N
authors.lastname: Weaver
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice and Division of Urologic Surgery, School of Medicine (KS, OD, SS), Saint Louis University, Saint Louis, Missouri.
authors.forename: Sameer
authors.initials: S
authors.lastname: Siddiqui
mesh_terms: D003657:Decision Making; D019468:Disease Management; D006801:Humans; D008297:Male; D010358:Patient Participation; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*
keywords: decision making; patients; physicians; prostatic neoplasms; standards