title: onlineDeCISion.org: a web-based decision aid for DCIS treatment.
abstract: Women diagnosed with DCIS face complex treatment decisions and often do so with inaccurate and incomplete understanding of the risks and benefits involved. Our objective was to create a tool to guide these decisions for both providers and patients. We developed a web-based decision aid designed to provide clinicians with tailored information about a patient’s recurrence risks and survival outcomes following different treatment strategies for DCIS. A theoretical framework, microsimulation model (Soeteman et al., J Natl Cancer 105:774–781, 2013) and best practices for web-based decision tools guided the development of the decision aid. The development process used semi-structured interviews and usability testing with key stakeholders, including a diverse group of multidisciplinary clinicians and a patient advocate. We developed onlineDeCISion.​org to include the following features that were rated as important by the stakeholders: (1) descriptions of each of the standard treatment options available; (2) visual projections of the likelihood of time-specific (10-year and lifetime) breast-preservation, recurrence, and survival outcomes; and (3) side-by-side comparisons of down-stream effects of each treatment choice. All clinicians reviewing the decision aid in usability testing were interested in using it in their clinical practice. The decision aid is available in a web-based format and is planned to be publicly available. To improve treatment decision making in patients with DCIS, we have developed a web-based decision aid onlineDeCISion.​org that conforms to best practices and that clinicians are interested in using in their clinics with patients to better inform treatment decisions.
authors.forename: Elissa M
authors.initials: EM
authors.lastname: Ozanne
authors.forename: Katharine H
authors.initials: KH
authors.lastname: Schneider
authors.forename: Djøra
authors.initials: D
authors.lastname: Soeteman
authors.forename: Natasha
authors.initials: N
authors.lastname: Stout
authors.forename: Deborah
authors.initials: D
authors.lastname: Schrag
authors.forename: Michael
authors.initials: M
authors.lastname: Fordis
authors.forename: Rinaa S
authors.initials: RS
authors.lastname: Punglia
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D020407:Internet; D008327:Mammography; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation