title: A Decision Aid for Women Considering Neoadjuvant Systemic Therapy for Operable Invasive Breast Cancer: Development and Protocol of a Phase II Evaluation Study (ANZ1301 DOMINO).
abstract: BACKGROUND
  Neoadjuvant systemic therapy is offered to selected women with large and/or highly proliferative operable breast cancers. This option adds further complexity to an already complex breast cancer treatment decision tree. Patient decision aids are an established method of increasing patient involvement and knowledge while decreasing decisional conflict. There is currently no decision aid available for women considering neoadjuvant systemic therapy.
  
  
  OBJECTIVE
  We aimed to develop a decision aid for women diagnosed with operable breast cancer and considered suitable for neoadjuvant systemic therapy, and the protocol for a multicenter pre-post study evaluating the acceptability and feasibility of the decision aid.
  
  
  METHODS
  The decision aid was developed through literature review, expert advisory panel, adherence to the International Patient Decision Aid Standards, and iterative review. The protocol for evaluation of the decision aid consists of the following: eligible women will undertake a series of questionnaires prior to and after using the decision aid. The primary endpoint is decision aid acceptability to patients and investigators and the feasibility of use. Secondary endpoints include change in decisional conflict, participant knowledge, and information involvement preference. Feasibility is defined as the proportion of eligible participants who use the decision aid to help inform their treatment decision.
  
  
  RESULTS
  This study has recruited 29 out of a planned 50 participants at four Australian sites. A 12-month recruitment period is expected with a further 12-months follow-up.
  
  
  CONCLUSIONS
  The decision aid has the potential to allow patients with operable breast cancer, who have been offered neoadjuvant systemic therapy, decreased decisional conflict, and greater involvement in the decision. If this study finds that an online decision aid is feasible and acceptable, it will be made widely available for routine clinical practice.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registry ACTRN12614001267640; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12614001267640&isBasic=True (Archived by WebCite at http://www.webcitation.org/6gh7BPZdG).
authors.affiliation: Northern Clinical School, Faculty of Medicine, University of Sydney, North Sydney, Australia. nick.zdenkowski@newcastle.edu.au.
authors.forename: Nicholas
authors.identifier: http://orcid.org/0000-0001-8738-8463
authors.initials: N
authors.lastname: Zdenkowski
authors.forename: Phyllis
authors.identifier: http://orcid.org/0000-0003-3562-6954
authors.initials: P
authors.lastname: Butow
authors.forename: Elizabeth
authors.identifier: http://orcid.org/0000-0002-6030-954X
authors.initials: E
authors.lastname: Hutchings
authors.forename: Charles
authors.identifier: http://orcid.org/0000-0001-7952-068X
authors.initials: C
authors.lastname: Douglas
authors.forename: Joseph R
authors.identifier: http://orcid.org/0000-0002-8928-0656
authors.initials: JR
authors.lastname: Coll
authors.forename: Frances M
authors.identifier: http://orcid.org/0000-0003-3798-1570
authors.initials: FM
authors.lastname: Boyle
keywords: breast neoplasm; chemotherapy; decision aid; neoadjuvant; protocol