Assessing the quality and communicative aspects of patient decision aids for early-stage breast cancer treatment: a systematic review

Ruben Vromans, Kim Tenfelde, Steffen Pauws, Mies van Eenbergen, Ingeborg Mares-Engelberts, Galina Velikova, L.V. van de Poll-Franse, Emiel Krahmer

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Abstract

Purpose
Decision aids (DAs) support patients in shared decision-making by providing balanced evidence-based treatment information and eliciting patients’ preferences. The purpose of this systematic review was to assess the quality and communicative aspects of DAs for women diagnosed with early-stage breast cancer.

Methods
Twenty-one currently available patient DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) and online sources. The DAs were reviewed for their quality by using the International Patient Decision Aid Standards (IPDAS) checklist, and subsequently assessed to what extent they paid attention to various communicative aspects, including (i) information presentation, (ii) personalization, (iii) interaction, (iv) information control, (v) accessibility, (vi) suitability, and (vii) source of information.

Results
The quality of the DAs varied substantially, with many failing to comply with all components of the IPDAS criteria (mean IPDAS score = 64%, range 31–92%). Five aids (24%) did not include any probability information, 10 (48%) presented multimodal descriptions of outcome probabilities (combining words, numbers, and visual aids), and only 2 (10%) provided personalized treatment outcomes based on patients and tumor characteristics. About half (12; 57%) used interaction methods for eliciting patients’ preferences, 16 (76%) were too lengthy, and 5 (24%) were not fully accessible.

Conclusions
In addition to the limited adherence to the IPDAS checklist, our findings suggest that communicative aspects receive even less attention. Future patient DA developments for breast cancer treatment should include communicative aspects that could influence the uptake of DAs in daily clinical practice.
Original languageEnglish
Pages (from-to)1-15
JournalBreast Cancer Research and Treatment
DOIs
Publication statusPublished - 2019

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Decision Support Techniques
Patient Preference
Checklist
MEDLINE

Keywords

  • Breast cancer
  • Decision aids
  • Shared decision-making
  • Risk communication
  • Patient education
  • Treatment decision-making
  • Decision support techniques

Cite this

@article{f4634e8193634aeba8fb27ff282081eb,
title = "Assessing the quality and communicative aspects of patient decision aids for early-stage breast cancer treatment: a systematic review",
abstract = "PurposeDecision aids (DAs) support patients in shared decision-making by providing balanced evidence-based treatment information and eliciting patients’ preferences. The purpose of this systematic review was to assess the quality and communicative aspects of DAs for women diagnosed with early-stage breast cancer.MethodsTwenty-one currently available patient DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) and online sources. The DAs were reviewed for their quality by using the International Patient Decision Aid Standards (IPDAS) checklist, and subsequently assessed to what extent they paid attention to various communicative aspects, including (i) information presentation, (ii) personalization, (iii) interaction, (iv) information control, (v) accessibility, (vi) suitability, and (vii) source of information.ResultsThe quality of the DAs varied substantially, with many failing to comply with all components of the IPDAS criteria (mean IPDAS score = 64{\%}, range 31–92{\%}). Five aids (24{\%}) did not include any probability information, 10 (48{\%}) presented multimodal descriptions of outcome probabilities (combining words, numbers, and visual aids), and only 2 (10{\%}) provided personalized treatment outcomes based on patients and tumor characteristics. About half (12; 57{\%}) used interaction methods for eliciting patients’ preferences, 16 (76{\%}) were too lengthy, and 5 (24{\%}) were not fully accessible.ConclusionsIn addition to the limited adherence to the IPDAS checklist, our findings suggest that communicative aspects receive even less attention. Future patient DA developments for breast cancer treatment should include communicative aspects that could influence the uptake of DAs in daily clinical practice.",
keywords = "Breast cancer, Decision aids, Shared decision-making, Risk communication, Patient education, Treatment decision-making, Decision support techniques",
author = "Ruben Vromans and Kim Tenfelde and Steffen Pauws and {van Eenbergen}, Mies and Ingeborg Mares-Engelberts and Galina Velikova and {van de Poll-Franse}, L.V. and Emiel Krahmer",
year = "2019",
doi = "10.1007/s10549-019-05351-4",
language = "English",
pages = "1--15",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",

}

TY - JOUR

T1 - Assessing the quality and communicative aspects of patient decision aids for early-stage breast cancer treatment

T2 - a systematic review

AU - Vromans, Ruben

AU - Tenfelde, Kim

AU - Pauws, Steffen

AU - van Eenbergen, Mies

AU - Mares-Engelberts, Ingeborg

AU - Velikova, Galina

AU - van de Poll-Franse, L.V.

AU - Krahmer, Emiel

PY - 2019

Y1 - 2019

N2 - PurposeDecision aids (DAs) support patients in shared decision-making by providing balanced evidence-based treatment information and eliciting patients’ preferences. The purpose of this systematic review was to assess the quality and communicative aspects of DAs for women diagnosed with early-stage breast cancer.MethodsTwenty-one currently available patient DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) and online sources. The DAs were reviewed for their quality by using the International Patient Decision Aid Standards (IPDAS) checklist, and subsequently assessed to what extent they paid attention to various communicative aspects, including (i) information presentation, (ii) personalization, (iii) interaction, (iv) information control, (v) accessibility, (vi) suitability, and (vii) source of information.ResultsThe quality of the DAs varied substantially, with many failing to comply with all components of the IPDAS criteria (mean IPDAS score = 64%, range 31–92%). Five aids (24%) did not include any probability information, 10 (48%) presented multimodal descriptions of outcome probabilities (combining words, numbers, and visual aids), and only 2 (10%) provided personalized treatment outcomes based on patients and tumor characteristics. About half (12; 57%) used interaction methods for eliciting patients’ preferences, 16 (76%) were too lengthy, and 5 (24%) were not fully accessible.ConclusionsIn addition to the limited adherence to the IPDAS checklist, our findings suggest that communicative aspects receive even less attention. Future patient DA developments for breast cancer treatment should include communicative aspects that could influence the uptake of DAs in daily clinical practice.

AB - PurposeDecision aids (DAs) support patients in shared decision-making by providing balanced evidence-based treatment information and eliciting patients’ preferences. The purpose of this systematic review was to assess the quality and communicative aspects of DAs for women diagnosed with early-stage breast cancer.MethodsTwenty-one currently available patient DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) and online sources. The DAs were reviewed for their quality by using the International Patient Decision Aid Standards (IPDAS) checklist, and subsequently assessed to what extent they paid attention to various communicative aspects, including (i) information presentation, (ii) personalization, (iii) interaction, (iv) information control, (v) accessibility, (vi) suitability, and (vii) source of information.ResultsThe quality of the DAs varied substantially, with many failing to comply with all components of the IPDAS criteria (mean IPDAS score = 64%, range 31–92%). Five aids (24%) did not include any probability information, 10 (48%) presented multimodal descriptions of outcome probabilities (combining words, numbers, and visual aids), and only 2 (10%) provided personalized treatment outcomes based on patients and tumor characteristics. About half (12; 57%) used interaction methods for eliciting patients’ preferences, 16 (76%) were too lengthy, and 5 (24%) were not fully accessible.ConclusionsIn addition to the limited adherence to the IPDAS checklist, our findings suggest that communicative aspects receive even less attention. Future patient DA developments for breast cancer treatment should include communicative aspects that could influence the uptake of DAs in daily clinical practice.

KW - Breast cancer

KW - Decision aids

KW - Shared decision-making

KW - Risk communication

KW - Patient education

KW - Treatment decision-making

KW - Decision support techniques

U2 - 10.1007/s10549-019-05351-4

DO - 10.1007/s10549-019-05351-4

M3 - Article

SP - 1

EP - 15

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

ER -