TY - JOUR
T1 - Decreased use of adjuvant breast cancer therapy in a randomized controlled trial of a decision aid with individualized risk information
AU - Peele, Pamela B.
AU - Siminoff, Laura A.
AU - Xu, Ying
AU - Ravdin, Peter M.
PY - 2005/5
Y1 - 2005/5
N2 - Objective. Oncology patients often seek involvement in their medical consultations. Such involvement is endorsed by most health care providers and mirrored in practice guidelines. However, oncologists exhibit great variation in how they provide patients with disease-relevant information, and many remain reluctant to do so at all. The authors examined the impact of a patient-specific decision aid on women's decisions about adjuvant therapy for breast cancer. Method. 386 women with breast cancer were randomized to receive either an informational pamphlet about adjuvant therapy (usual care) or a patient-specific, evidence-based decision aid about adjuvant therapy. The authors compared rates of adjuvant therapy between the groups controlling for age, education, marital status, race, tumor severity, and practice type of their physician (university-based or community-based). Results. Among women with low tumor severity, only 58% (35/60) of women in the decision aid group chose adjuvant therapy, compared to 87% (33/38) of their counterparts in usual care (P < 0.01). Conclusions. This study illustrates the important impact of medical decision aids on treatment choices, particularly for patients for whom treatment has little benefit. In the case of adjuvant therapy for breast cancer, providing individualized, evidence-based risk information for shared decision making resulted in fewer women with low tumor severity choosing adjuvant treatment.
AB - Objective. Oncology patients often seek involvement in their medical consultations. Such involvement is endorsed by most health care providers and mirrored in practice guidelines. However, oncologists exhibit great variation in how they provide patients with disease-relevant information, and many remain reluctant to do so at all. The authors examined the impact of a patient-specific decision aid on women's decisions about adjuvant therapy for breast cancer. Method. 386 women with breast cancer were randomized to receive either an informational pamphlet about adjuvant therapy (usual care) or a patient-specific, evidence-based decision aid about adjuvant therapy. The authors compared rates of adjuvant therapy between the groups controlling for age, education, marital status, race, tumor severity, and practice type of their physician (university-based or community-based). Results. Among women with low tumor severity, only 58% (35/60) of women in the decision aid group chose adjuvant therapy, compared to 87% (33/38) of their counterparts in usual care (P < 0.01). Conclusions. This study illustrates the important impact of medical decision aids on treatment choices, particularly for patients for whom treatment has little benefit. In the case of adjuvant therapy for breast cancer, providing individualized, evidence-based risk information for shared decision making resulted in fewer women with low tumor severity choosing adjuvant treatment.
KW - Cancer
KW - Decision aid
KW - Decision making
KW - Information preferences
UR - http://www.scopus.com/inward/record.url?scp=18844439920&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=18844439920&partnerID=8YFLogxK
U2 - 10.1177/0272989X05276851
DO - 10.1177/0272989X05276851
M3 - Article
C2 - 15951457
AN - SCOPUS:18844439920
SN - 0272-989X
VL - 25
SP - 301
EP - 307
JO - Medical Decision Making
JF - Medical Decision Making
IS - 3
ER -