title: Treatment preference and patient centered prostate cancer care: Design and rationale.
abstract: Prostate cancer is a slow progressing cancer that affects millions of men in the US. Due to uncertainties in outcomes and treatment complications, it is important that patients engage in informed decision making to choose the "optimal treatment". Patient centered care that encompasses informed decision-making can improve treatment choice and quality of care. Thus, assessing patient treatment preferences is critical for developing an effective decision support system. The objective of this patient-centered randomized clinical trial was to study the comparative effectiveness of a conjoint analysis intervention compared to usual care in improving subjective and objective outcomes in prostate cancer patients. We identified preferred attributes of alternative prostate cancer treatments that will aid in evaluating attributes of treatment options. In this two-phase study, in Phase 1 we used mixed methods to develop an adaptive conjoint task instrument. The conjoint task required the patients to trade-off attributes associated with treatments by assessing their relative importance. Phase 2 consisted of a randomized controlled trial of men with localized prostate cancer. We analyzed the effect of conjoint task intervention on the association between preferences, treatment and objective and subjective outcomes. Our conjoint task instrument can lead to a values-based patient-centered decision aid tool and help tailor treatment decision making to the values of prostate cancer patients. This will ultimately improve clinical decision making, clinical policy process, enhance patient centered care and improve prostate cancer outcomes.
authors.affiliation: Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States. Electronic address: jravi@mail.med.upenn.edu.
authors.forename: Ravishankar
authors.initials: R
authors.lastname: Jayadevappa
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, United States.
authors.forename: Sumedha
authors.initials: S
authors.lastname: Chhatre
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, United States.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, United States.
authors.forename: Marsha
authors.initials: M
authors.lastname: Wittink
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania, United States.
authors.forename: Knashawn H
authors.initials: KH
authors.lastname: Morales
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States.
authors.forename: S
authors.initials: S
authors.lastname: Bruce Malkowicz
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States.
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States.
authors.forename: Thomas
authors.initials: T
authors.lastname: Guzzo
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States.
authors.forename: Adele
authors.initials: A
authors.lastname: Caruso
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, United States.
authors.forename: Keith
authors.initials: K
authors.lastname: Van Arsdalen
authors.affiliation: Division of Urology, Perelman School of Medicine, University of Pennsylvania, United States.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.affiliation: Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States.
authors.forename: J
authors.initials: J
authors.lastname: Sanford Schwartz
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000379:methods*; D057240:Patient Preference; D018802:Patient-Centered Care / Q000458:organization & administration*; D011471:Prostatic Neoplasms / Q000628:therapy*; D012107:Research Design
keywords: Conjoint analysis,; Patient reported outcomes; Patient-centered care,; Preference assessment,; Prostate cancer,