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 |