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Assessing The Adoption Of Shared Decision Making Using Decision Aids Among Urologists And Prostate Cancer Patients
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Book Synopsis Assessing the adoption of shared decision making using decision aids among urologists and prostate cancer patients by : Prajakta Adsul
Download or read book Assessing the adoption of shared decision making using decision aids among urologists and prostate cancer patients written by Prajakta Adsul and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Treatment Decision Making in Early-Stage Prostate Cancer: Evaluation of Computer-Based Patient Education and an Interactive Decision Aid by :
Download or read book Treatment Decision Making in Early-Stage Prostate Cancer: Evaluation of Computer-Based Patient Education and an Interactive Decision Aid written by and published by . This book was released on 2003 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study aims to examine a method of patient education for men who are seeking treatment for management of localized prostate cancer. The primary goal is to evaluate a recently developed computer-based educational tool (CD-ROM) that is designed to provide treatment-related information and to assist men in making an informed treatment decision. Men are accrued pre-biopsy for a baseline interview, and those who are diagnosed with localized cancer are randomized to receive a CD-ROM with a decision aid, or a CD-ROM with information only. To date, we have accessioned 97 patients. Of the 97, 36 were ineligible and 15 are pending (either pending initial contact or biopsy result). Of the remaining 46, 28 either declined or were unreachable, 2 dropped out and 16 are active with a CD-ROM. This results in a 35% participation rate (16/46). Because of the number of men who are ineligible, and who were unreachable prior to biopsy, we are seeking to expand the study to invite those already diagnosed with prostate cancer to consider participation. To that end, we aim to contact the Georgetown University Radiation Department and Georgetown University Medical Center Referral Center for accrual expansion.
Book Synopsis Decision Aids for Cancer Screening and Treatment by : Thomas A. Trikalinos
Download or read book Decision Aids for Cancer Screening and Treatment written by Thomas A. Trikalinos and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Many health decisions about screening and treatment for cancers involve uncertainty or tradeoffs between the expected benefits and harms. Patient decision aids have been developed to help health care consumers and their providers identify the available alternatives and choose the one that aligns with their values. It is unclear whether the effectiveness of decision aids for decisions related to cancers differs by people's average risk of cancer or by the content and format of the decision aid. OBJECTIVES: We sought to appraise and synthesize the evidence assessing the effectiveness of decision aids targeting health care consumers who face decisions about cancer screening or prevention, or early cancer treatment (Key Question 1), particularly with regard to decision aid or patient characteristics that might function as effect modifiers. We also reviewed interventions targeting providers for promotion of shared decision making using decision aids (Key Question 2). DATA SOURCES: We searched MEDLINE(r), Embase(r), the Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO(r), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL(r)) from inception to the end of June 2014. REVIEW METHODS: For Key Question 1, we included randomized controlled trials comparing decision aid interventions among themselves or with a control. We included trials of previously developed decision aids that were delivered at the point of the actual decision. We predefined three population groups of interest based on risk or presence of cancer (average cancer risk, high cancer risk, early cancer). The assessed outcomes pertained to measurements of decisional quality and cognition (e.g., knowledge scores), attributes of the decision-making process (e.g., Decisional Conflict Scale), emotion and quality of life (e.g., decisional regret), and process and system-level attributes. We assessed for effect modification by population group, by the delivery format or content of the decision aid or other attributes, or by methodological characteristics of the studies. For Key Question 2, we included studies of any intervention to promote patient decision aid use, regardless of study design and outcomes assessed. RESULTS: Of the 16,669 screened citations, 87 publications were eligible, corresponding to 83 (68 trials; 25,337 participants) and 5 reports for Key Questions 1 and 2, respectively. Regarding the evolution of the decision aid format and content over time, more recent trials increasingly studied decision aids that were more practical to deliver (e.g., over the Internet or without human mediation) and more often clarified preferences explicitly. Overall, participants using decision aids had higher knowledge scores compared with those not using decision aids (standardized mean difference, 0.23; 95% credible interval [CrI], 0.09 to 0.35; 42 comparison strata with 12,484 participants). Compared with not using decision aids, using decision aids resulted in slightly lower decisional conflict scores (weighted mean difference of -5.3 units [CrI, -8.9 to -1.8] on the 0-100 Decisional Conflict Scale; 28 comparison strata; 7,923 participants). There was no difference in State-Trait Anxiety Inventory scores (weighted mean difference = 0.1; 95% CrI, -1.0 to 0.7 on a 20-80 scale; 16 comparison strata; 2,958 participants). Qualitative synthesis suggested that patients using decision aids are more likely to make informed decisions and have accurate risk perceptions; further, they may make choices that best agree with their values and may be less likely to remain undecided. Because there was insufficient, sparse, or no information about effects of decision aids on patient-provider communication, patient satisfaction with decision-making process, resource use, consultation length, costs, or litigation rates, a quantitative synthesis was not done. There was no evidence for effect modification by population group, by the delivery format or content of the decision aid or other attributes, or by methodological characteristics of the studies. Data on Key Question 2 were very limited. CONCLUSIONS: Cancer-related decision aids have evolved over time, and there is considerable diversity in both format and available evidence. We found strong evidence that cancer-related decision aids increase knowledge without adverse impact on decisional conflict or anxiety. We found moderate- or low-strength evidence that patients using decision aids are more likely to make informed decisions, have accurate risk perceptions, make choices that best agree with their values, and not remain undecided. This review adds to the literature that the effectiveness of cancer-related decision aids does not appear to be modified by specific attributes of decision aid delivery format, content, or other characteristics of their development and implementation. Very limited information was available on other outcomes or on the effectiveness of interventions that target providers to promote shared decision making by means of decision aids.
Book Synopsis A Randomized Controlled Trial Comparing Internet and Video to Facilitate Shared Decision-making for Men Considering the Prostate Specific Antigen Test by : Dominick Ludwig Frosch
Download or read book A Randomized Controlled Trial Comparing Internet and Video to Facilitate Shared Decision-making for Men Considering the Prostate Specific Antigen Test written by Dominick Ludwig Frosch and published by . This book was released on 2003 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Little is known about the relative advantages of video versus internet-based decision aids to facilitate shared medical decision making. This study compared internet and video patient education modalities for men considering the prostate specific antigen (PSA) test. METHODS: Two hundred and twenty-six men, aged 50 years or older, and scheduled to complete a physical examination at an HMO Health Appraisal Clinic were randomly assigned to access a website (N=114) or view a 23-minute videotape in the clinic (N=112) prior to deciding whether they wanted to be screened for prostate cancer. RESULTS: There were no between-groups differences in participants' ratings of convenience, effort, or satisfaction following exposure to the decision aid. Participants assigned to the video group were more likely to review the materials than individuals assigned to the internet group (98.2% vs 53.5%). Participants in the video group showed significantly greater increases in PSA knowledge and were more likely to decline the PSA test than individuals assigned to the internet group. However, participants in the internet group who reviewed the entire online presentation showed similar increases in PSA knowledge as video participants. Only 5% of all participants visited other websites to inform themselves about the PSA test. CONCLUSIONS: Overall, the video was significantly more effective than the Internet in educating participants about benefits and risks of PSA screening.
Book Synopsis Treatment Decision Making in Early-Stage Prostate Cancer: Evaluation of Computer-Based Patient Education by :
Download or read book Treatment Decision Making in Early-Stage Prostate Cancer: Evaluation of Computer-Based Patient Education written by and published by . This book was released on 2005 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study examined a method of patient education for men who were seeking treatment for management of localized prostate cancer. The primary goal was to evaluate a recently developed computer-based educational tool (CD-ROM) that was designed to provide treatment-related information and to assist men in making an informed treatment decision. Men were accrued post-biopsy for a baseline interview, and were randomized to receive a CD-ROM with a decision aid, or a CD-ROM with information only. We have completed accrual, randomization, and the baseline and one-month follow-up interviews. The study participation rate was 81.6% (133/163). Currently, we have completed the one-month follow-up interviews, and the six- and 12-month follow-up interviews will be completed within the next 8 months. We have conducted preliminary analyses of the baseline and one-month follow-up data, and will complete the analyses once data collection has concluded.
Book Synopsis Impact of Cancer-related Decision Aids by : Tim J. Whelan
Download or read book Impact of Cancer-related Decision Aids written by Tim J. Whelan and published by . This book was released on 2002 with total page 412 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Shared Decision-Making in Prostate Cancer Treatment by : Jessy M. Johnson
Download or read book Shared Decision-Making in Prostate Cancer Treatment written by Jessy M. Johnson and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Patterns of Use and Patient Perceptions of a Decision Support Software Tool for Men with Early Stage Prostate Cancer by : Linda Fleisher
Download or read book Patterns of Use and Patient Perceptions of a Decision Support Software Tool for Men with Early Stage Prostate Cancer written by Linda Fleisher and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Public Health
Book Synopsis The Effects of Shared Decision Making on Cancer Screening by : Sarah E. Lillie
Download or read book The Effects of Shared Decision Making on Cancer Screening written by Sarah E. Lillie and published by . This book was released on 2014 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt: Decisions about cancer screening have become increasingly complex. Patients must decide whether to get screened, which screening modality to use, and how often to undergo and when to stop screening. Some cancer screening decisions are considered "preference-sensitive," meaning that, due to closely-balanced benefits and harms, the "right" decision is in part dependent on an individual's values and preferences for particular outcomes. Most organizations publishing clinical practice guidelines for cancer screening now recommend that preference-sensitive cancer screening decisions be made individually, using a process that considers the available evidence on the benefits and harms of particular options, and incorporates patient values and preferences relevant to those options. This approach is sometimes referred to as shared decision making (SDM). The goal of SDM interventions is to facilitate this approach. Adjuncts for the usual counseling for specific decisions, SDM interventions may include: (1) tools to help patients comprehend information about the risks and benefits of options, clarify their personal values related to these options, and participate in decisions consistent with these values and preferences (sometimes referred to as "decision aids") and (2) other interventions to prepare health care providers and/or systems to support this process. SDM interventions differ from many health-related interventions in that they primarily seek to elicit and support patient values and preferences in making health care-related decisions rather than to promote a particular health care strategy per se. In this review we examine the effects of SDM interventions for cancer screening in adults on constructs from the Ottawa Decision Support Framework, a commonly-used theoretical model of decision making. We examined the constructs of Decision Quality, Decision Impact, and, for studies reporting those outcomes, Decision Action. Decision Quality includes knowledge, values clarity (patients' clarity of their personal values regarding the risks and benefits of decision options), and the patients' participatory role in decision making. Decision Impact includes decisional conflict (personal uncertainty about which course of action to take), use of services (eg, consultation length), and satisfaction with the decision. Decision Action includes screening intention and behavior. The ideal SDM intervention would enhance Decision Quality (ie, increase knowledge and values clarity) and Impact (ie, increase satisfaction, reduce decision conflict, and have minimal impact on service utilization). The desired impact on Decision Action depends on the screening decision. For decisions about how to screen (such as colorectal cancer screening), the ideal SDM intervention would exert the desired effects on Decision Quality and Impact without reducing measures of Decision Action such as screening intention and behavior. For decisions about whether to screen (such as breast, cervical, and prostate cancer in some age groups and risk categories), the goal is to facilitate personalized decision making based on values and preferences. Hence, there are no desired effects on Decision Action per se in this context. We examine patient, provider, system, and multi-level SDM interventions, and therefore do not restrict this review to the most commonly employed SDM intervention of patient-directed decision aids. This topic was nominated by Linda Kinsinger, MD, MPH, VA Chief Consultant for Preventive Medicine at the VA National Center for Health Promotion and Disease Prevention (NCP). The evidence review is intended to examine the effects of SDM interventions for cancer screening practices and to inform what types of interventions NCP will disseminate with their cancer screening guidelines.
Book Synopsis Value-Based Decision-Making in Prostate Cancer Early Detection by :
Download or read book Value-Based Decision-Making in Prostate Cancer Early Detection written by and published by . This book was released on 1999 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Proponents of prostate cancer early detection argue that the combination of digital rectal examination and prostate-specific antigen testing is effective and that early detection leads to improved chances for survival. Others caution against routine screening because no mortality benefit has been shown in randomized trials and treatment of diagnosed prostate cancer can have serious side effects. Typically, patients who undergo testing are not aware of these uncertainties and do not participate in deciding whether to screen. We are conducting a prospective study with men 50-69 years of age to evaluate the efficacy of a counseling intervention designed to promote value-based decision-making. A baseline survey questionnaire will be administered to measure demographic, cognitive, and psychosocial characteristics. A Standard Intervention Group will receive a generic educational booklet about prostate cancer early detection. Enhanced Intervention Group men will receive a theory-based educational counseling session the booklet will be enhanced by an Analytic Hierarchy Process educational counseling session delivered by a nurse educator. The session will engage participants in a personally-tailored process of evaluating whether to have or not have an early detection exam. The behavioral outcome will be the proportion of men in each group who have an early detection exam during a six month follow up period. This outcome will be measured using data obtained via medical chart audit. Cognitive and psychosocial outcomes will be assessed using endpoint survey data.
Book Synopsis Implementation of the P3P by : Victoria L. Anderson
Download or read book Implementation of the P3P written by Victoria L. Anderson and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deciding on a treatment for low-grade localized prostate cancer is difficult for menbecause in most cases, no one treatment is better than the other. Shared decision-making (SDM) is the standard of care and is ideal for deciding in this case. One element of the SDM process is a decision tool. The Personal Patient Preference-Prostate (P3P) is a validated interactive webbased tool to help men decide treatment for their cancer. This evidence-based project (EBP) introduced the P3P as an adjunct to the shared decision-making experience for men with lowgrade localized prostate cancer into three federally funded clinics. Forty-five men agreed to participate, and twenty-two men completed both surveys. The cohort of men had a high baseline level of understanding and confidence; however, the post-survey results suggested these men increased their knowledge of their cancer and treatment options and that the P3P improved their clinic experience (83%). Most respondents strongly agreed, agreed, or somewhat agreed that the P3P improved their knowledge of prostate cancer and treatments (92%-95%) and decreased the stress associated with making a treatment decision (80%). Furthermore,70% strongly agreed, agreed, or somewhat agreed that the P3P helped narrow down treatment options.
Book Synopsis Decision Making Concepts of Men Diagnosed with Early Stage Prostate Cancer by : Ellen D. Nichols
Download or read book Decision Making Concepts of Men Diagnosed with Early Stage Prostate Cancer written by Ellen D. Nichols and published by . This book was released on 1990 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Treatment Decisions in Localized Prostate Cancer: Patient, Partner, and Physician by :
Download or read book Treatment Decisions in Localized Prostate Cancer: Patient, Partner, and Physician written by and published by . This book was released on 2001 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Treatment Decisions in Localized Prostate Cancer: Patient, Partner and Physician," is a project that aims to develop and refine an innovative new model of prostate cancer decision making, that will form the foundation of a research and clinical program to understand, support and improve decision making in prostate cancer. This project is using a cross-sectional survey to explore the role of the patient, partner and physician in treatment decisions and to examine the effect of preferences, perceived preferences, and actual preferences on treatment decisions, decision satisfaction and decision process. Many valuable steps have been taken in the first year of this grant, including the development of a pilot questionnaire, administration of the pilot questionnaire, development of the protocol for the study and development of patient, spouse and physician questionnaires. Enrollment for the study began in November, 2000.
Book Synopsis Understanding, Measuring and Improving Clinical Decision-making in Urological Cancer Multidisciplinary Team Meetings by : Benjamin Wilfrid Lamb
Download or read book Understanding, Measuring and Improving Clinical Decision-making in Urological Cancer Multidisciplinary Team Meetings written by Benjamin Wilfrid Lamb and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer care in many countries is delivered by healthcare professionals working together as multidisciplinary teams (MDTs). In the UK the delivery of care by MDTs is mandatory. The aims of the research reported here were to investigate the factors that affect the quality of clinical decision-making in MDT meetings, to develop and evaluate tools to measure this process, and to use these tools to evaluate interventions designed to improve the quality of such decisions. The introduction presents an overview of the evidence for clinical decision-making in MDT meetings, before Chapter 2 provides a critical appraisal of existing evidence, focussing on specific factors that affect decision-making by MDTs. My first empirical Chapters have explored the attitudes and experiences of MDT members and patients. Chapters 3 and 4 present analyses of national survey data that explore the views of MDT members from different professional groups across a range of tumour types. Chapters 5 and 6 present data from in-depth exploration of the views of urology MDT members and cancer patients respectively. Chapters 8 and 9 present data from studies that develop and cross-validate an observational tool for the assessment of decision-making in MDT meetings (MDT-MODe). I have used this tool in Chapter 10 to assess the relationship between organisational factors, information use, teamworking and decision-making in urology MDT meetings. Having built up a picture of the factors that are important for good decision-making, Chapter 11 reports a study that uses MDT-MODe to evaluate a multistage intervention to improve the quality of decision-making in urological MDT meetings. Finally, my general discussion reflects on the findings and the wider evidence base, explores the limitations and presents implications of my work for clinical practice, patient care, future research and policy.
Book Synopsis Assessing Patient Values Towards Prostate Cancer Genetic Screening by :
Download or read book Assessing Patient Values Towards Prostate Cancer Genetic Screening written by and published by . This book was released on 1999 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The project, "Assessing Patient Values Towards Prostate Cancer Genetic Screening", has begun to determine the values, beliefs, and attitudes that influence a man's decision to undergo or defer genetic testing for prostate cancer risk. The project consists of two stages: (1) the completed Focus Group Phase, in which 12 focus groups of a total of 90 men have identified key values and beliefs regarding genetic testing for prostate cancer risk. These results have allowed for the construction of a draft survey instrument; and, (2) the Survey Phase in Years 2 & 3, in which the draft survey instrument will first be pilot tested, with final refinement afterwards, followed by a survey to be administered to 300 men recruited from the waiting rooms at three primary care sites. The survey will evaluate those relevant values, social factors, attitudes, and beliefs that are relevant to genetic screening for prostate cancer risk. As a result, this project will help better understand the decision making of men concerning genetic screening for prostate cancer risk, and will help health professionals who will counsel these men in the decision making process.
Book Synopsis Evaluating the Feasibility of Developing National Outcomes Data Bases to Assist Patients with Making Treatment Decisions by : Cheryl Damberg
Download or read book Evaluating the Feasibility of Developing National Outcomes Data Bases to Assist Patients with Making Treatment Decisions written by Cheryl Damberg and published by Minnesota Historical Society. This book was released on 2003 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report examines issues surrounding the establishment of a national patient outcomes database that would be used by patients and providers to make more informed treatment decisions. It focuses on prostate cancer and surgery for osteoarthritis. The authors conclude that such longitudinal databases would be both desirable and feasible but would require substantial resources.
Book Synopsis Decision Aids in Patient-physician Communication for Supporting Shared Decision Making and Patient Satisfaction by : Bushra Salous
Download or read book Decision Aids in Patient-physician Communication for Supporting Shared Decision Making and Patient Satisfaction written by Bushra Salous and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
