Communicative aspects of decision aids for prostate cancer treatment: State of affairs, limitations, and recommendations

Despite increased interest in the development of decision aids (DAs) in prostate cancer care, little attention has been paid to communicative aspects of such tools. In this systematic review, we identified nineteen DAs for localized prostate cancer treatment through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO; 1990-2018) and online sources, and reviewed them for International Patient Decision Aids Standards (IPDAS) criteria and various communicative aspects. Results revealed variations in the use of IPDAS criteria and communicative aspects by DAs: (1) Few used visual aids to present (statistical) information, (2) none communicated personalized outcome probabilities, (3) a minority used interactive methods to elicit patients’ values and preferences, and (4) most included biased side-by-side displays to compare treatment options. These issues may encourage communication researchers to develop intervention strategies for improving communicative aspects of DAs, which may lead to increased patient participation and understanding of treatments during shared decision making.