title: Evaluating a Decision Aid for Improving Decision Making in Patients with Early-stage Breast Cancer.
abstract: BACKGROUND
  Early-stage breast cancer patients face a series of complex treatment decisions, with the first typically being choice of locoregional treatment. There is a need for tools to support patients in this decision-making process.
  
  
  METHODS
  We developed an innovative, online locoregional treatment tool based on International Patient Decision Aids Standards criteria. We evaluated its impact on patient knowledge about treatment and appraisal of decision making in a pilot study using a clinical sample of newly diagnosed, breast cancer patients who were randomized to view the decision aid website first or complete a survey prior to viewing the decision aid. Differences in knowledge and decision appraisal between the two groups were compared using t-tests and chi-square tests. Computer-generated preferences for treatment were compared with patients' stated preferences using chi-square tests.
  
  
  RESULTS
  One hundred and one newly diagnosed patients were randomized to view the website first or take a survey first. Women who viewed the website first had slightly higher, though not significantly, knowledge about surgery (p = 0.29) and reconstruction (p = 0.10) than the survey-first group. Those who viewed the website first also appraised their decision process significantly more favorably than did those who took the survey first (p < 0.05 for most decision outcomes). There was very good concordance between computer-suggested and stated treatment preferences.
  
  
  CONCLUSIONS
  This pilot study suggests that an interactive decision tool shows promise for supporting early-stage breast cancer patients with complicated treatment decision making.
authors.affiliation: Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. sarahawl@umich.edu.|Ann Arbor VA Healthcare System, Ann Arbor, MI, USA. sarahawl@umich.edu.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Newman
authors.affiliation: Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Griggs
authors.affiliation: Karmanos Cancer Institute, Detroit, MI, USA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Kosir
authors.affiliation: Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016462:Mammaplasty / Q000523:psychology / Q000706:statistics & numerical data; D008408:Mastectomy / Q000145:classification / Q000379:methods / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation; D057240:Patient Preference / Q000523:psychology* / Q000706:statistics & numerical data