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Table 2 Evaluated tools

From: The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review

Name tool/short description First author (year) Study populationa Design Decision aid outcome measures Outcome GRADE
CONNECT Meropol (2013) Metastatic cancer patients,
n = 629 (F:48%),
mean age: 59 year
Randomized clinical trial with 3 arms Consultation content, treatment outcome expectations, decisional conflict, patient satisfaction with the content and format of the communication, and satisfaction with the survey and/or communication skills training • Treatment decisions were easier to reach (P = 0.003)
• Patients were more satisfied with decisions (P < 0.001)
• Patients were more satisfied with physician communication (P = 0.026)
• Patients were more satisfied with discussion regarding support services (P = 0.029) and quality of life concerns (P = 0.042)
• No statistically significant differences in satisfaction regarding discussion of diagnosis/prognosis, treatment options, or support/community services.
Low
Decision aid on first, second, third and fourth line chemotherapy Smith (2011) Patients with metastatic breast, colorectal or lung cancer,
n = 27 (F:56%),
mean age: 63 year
Pilot pretest, posttest study Number of patients who opt for full disclosure once they viewed the DA
The amount of information patients have about cure, response rates, and symptom control; the impact of truthful information on hope, whether the information was deemed helpful to the patient; and whether the patient want to share the information with a physician
• 96% of the patients chose to complete the DA
• The proportion of patients who thought that advanced cancer could be cured reduced from 52 to 31% (P = 0.15)
• 87% of the patients overestimated the effect of palliative chemotherapy
• No distress was noted and hope did not change
• 74% found the information helpful
• 93% wanted to share the information with their family and physician
Very low
Decision aid on first-line chemotherapy Chiew (2008) Metastatic breast
cancer patients,
n = 17 (F:100%),
median age: 58 year
Medical oncologists, n = 7
Pilot observational study Patients’ attitudes toward the DA, and oncologist feedback regarding attitudes toward the DA. • The DA was rated acceptable and helpful.
• The DA contains an appropriate amount of information, and the length is appropriate
• 94% of the patients would recommend use of the DA to others
• Oncologists received the DA positively and found it appropriate for all or most patients
Very low
Decision aid on second-line chemotherapy Oostendorp (2017) Patients with metastatic breast or colorectal cancer, n = 128 (F:63%), median age: 62 year Randomized clinical trial Anxiety, depression, general health, cancer worries, health-related quality of life, coping styles, amount of information received, satisfaction with quality of information, subjective knowledge, treatment preference, decision satisfaction and uncertainty, decision control and treatment attitudes. • The DA had no adverse impact on patient’s well-being
• Use of the DA was associated with stronger treatment preferences (P = 0.030) and increased subjective knowledge (P = 0.022)
• No statistically significant differences in anxiety, depression, general health, cancer worries, health-related quality of life, coping styles, amount of information received, satisfaction with quality of information, decision satisfaction and uncertainty, decision control and treatment attitudes.
Moderate
Living with Metastatic Breast Cancer: Making the Journey Your Own Sepucha (2009) Metastatic breast cancer patients,
n = 32 (F:100%), median age: 55 year
Pilot pretest, posttest study Use and acceptability of DA, distress, treatment goals, and preference for and actual participation in decision • The DA was rated acceptable and did not increase distress (P = 0.34)
• Most patients (88%) desired to share decision making with their physician
• 41% of the patients found that decision making was shared
• 38% achieved their desired level of participation
• The main goal of treatment was most often to lengthen life
Very low
  1. Note. aStudy population: n sample size, F female, NA not applicable
  2. DA decision aid