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Randomized Trial of a Patient Decision Aid for Choice of Surgical Treatment for Breast Cancer

Author

Listed:
  • Vivek Goel

    (Institute for Clinical Evaluative Sciences, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Departments of Health Administration)

  • Carol A. Sawka

    (Institute for Clinical Evaluative Sciences, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Departments of Medicine)

  • Elaine C. Thiel

    (Institute for Clinical Evaluative Sciences, Toronto)

  • Elaine H. Gort

    (Institute for Clinical Evaluative Sciences, Toronto)

  • Annette M. O’Connor

    (University of Toronto, Toronto; and University of Ottawa, Ottawa)

Abstract

A decision aid for the surgical treatment of early breast cancer was evaluated in a randomized controlled trial. The decision aid, a tape and workbook, includes explicit presentation of probabilities, photographs and graphics, and a values clarification exercise. Community surgeons were randomized to use the decision aid or a control pamphlet. Patients completed a questionnaire prior to using the decision aid, after reviewing it but prior to surgery, and 6 months after enrollment. There was no difference in anxiety, knowledge, or decisional regret across the 2 groups. There was a nonsignificant trend toward lower decisional conflict in the decision aid group. A subgroup of women who were initially leaning toward mastectomy or were unsure had lower decisional conflict. Although the decision aid had minimal impact on the main study outcomes, a subgroup may have benefited. Such subgroups should be identified, and appropriate decision support interventions should be developed and evaluated.

Suggested Citation

  • Vivek Goel & Carol A. Sawka & Elaine C. Thiel & Elaine H. Gort & Annette M. O’Connor, 2001. "Randomized Trial of a Patient Decision Aid for Choice of Surgical Treatment for Breast Cancer," Medical Decision Making, , vol. 21(1), pages 1-6, February.
    • Handle: RePEc:sae:medema:v:21:y:2001:i:1:p:1-6
    DOI: 10.1177/0272989X0102100101
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    References listed on IDEAS

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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Morris, Jenny & Royle, G. T., 1988. "Offering patients a choice of surgery for early breast cancer: A reduction in anxiety and depression in patients and their husbands," Social Science & Medicine, Elsevier, vol. 26(6), pages 583-585, January.
    3. Llewellyn-Thomas, H. A. & McGreal, M. J. & Thiel, E. C. & Fine, S. & Erlichman, C., 1991. "Patients' willingness to enter clinical trials: Measuring the association with perceived benefit and preference for decision participation," Social Science & Medicine, Elsevier, vol. 32(1), pages 35-42, January.
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