Background: Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement.
Objectives: We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting.
Methods: Men with incident localized prostate cancer (n = 122) were recruited from the Greater Los Angeles Veterans Affairs (VA) Medical Center urology clinic, Olive View UCLA Medical Center, and Harbor UCLA Medical Center from January 2011 to May 2015 and randomized to education with a brochure about prostate cancer treatment or software-based preference assessment in addition to the brochure. Men undergoing preference assessment received a report detailing the relative strength of their preferences for treatment outcomes used in review with their doctor. Participants completed instruments measuring decisional conflict, knowledge, SDM, and patient satisfaction with care before and/or after their cancer consultation.
Results: Baseline knowledge scores were low (mean 62%). The baseline mean total score on the Decisional Conflict Scale was 2.3 (±0.9), signifying moderate decisional conflict. Men undergoing preference assessment had a significantly larger decrease in decisional conflict total score (p = 0.023) and the Perceived Effective Decision Making subscale (p = 0.003) post consult compared with those receiving education only. Improvements in satisfaction with care, SDM, and knowledge were similar between groups.
Conclusions: Individual-level preference assessment is feasible in the clinic setting. Patients with prostate cancer who undergo preference assessment are more certain about their treatment decisions and report decreased levels of decisional conflict when making these decisions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s40271-017-0255-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rates and Predictors of Malignancy in Bethesda III and IV Thyroid Nodules: A Prospective Study.
Cureus
December 2024
Internal Medicine, University of Alexandria, Alexandria, EGY.
Aim: Thyroid nodules, based on high-resolution ultrasonography (HRUS), are among the most common endocrine abnormalities that affect the general population because of their high estimated prevalence rates. Fine needle aspiration cytology (FNAC) is a safe, cost-effective modality to differentiate between benign and malignant thyroid nodules based on the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), thus avoiding unnecessary surgery. However, categories III and IV of BSRTC remain a controversial issue in clinical practice, encompassing a wide range of risks of malignancy.
View Article and Find Full Text PDFShifting tides: A survey analysis of urologists' evolving attitudes toward focal therapy for prostate cancer.
Indian J Urol
January 2025
Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Introduction: Focal therapy (FT) is emerging as an alternative to radical treatment for prostate cancer (CaP). The purpose of this study is to assess the current perceptions of FT amongst urologists.
Methods: A 22-item questionnaire was e-mailed to members of the American Urological Association.
Methods and Efficacy of Processing Testicular Sperm Samples in Obstructive and Non-Obstructive Azoospermia: A Systematic Review.
J Mens Health
November 2024
The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD.
Intracytoplasmic sperm injection (ICSI) is a cornerstone in managing male infertility, especially in obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), necessitating sperm retrieval via testicular sperm extraction (TESE) or microdissection TESE (mTESE). However, the varied post-sperm extraction processing methods pose uncertainty regarding optimal approaches. To address this, a systematic review following preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines was conducted, identifying 16 relevant studies.
View Article and Find Full Text PDFPress-Fit Bone-Anchored Prosthesis for Individuals with Transtibial Amputation.
JBJS Essent Surg Tech
May 2024
Radboud University Medical Center, Nijmegen, The Netherlands.
Background: This video article describes the use of bone-anchored prostheses for patients with transtibial amputations, most often resulting from trauma, infection, or dysvascular disease. Large studies have shown that about half of all patients with a socket-suspended artificial limb experience limited mobility and limited prosthesis use because of socket-related problems. These problems occur at the socket-residual limb interface as a result of a painful and unstable connection, leading to an asymmetrical gait and subsequent pelvic and back pain.
View Article and Find Full Text PDFDouble Fortified Salt Containing Iodine and Folic Acid and Triple Fortified Salt Containing Iodine, Folic Acid, and Vitamin B Are Acceptable to Ethiopian Women of Reproductive Age.
Food Sci Nutr
January 2025
Department of Nutrition and Institute for Global Nutrition University of California, Davis Davis California USA.
Recognizing the broader accessibility of iodized salt compared to wheat flour, the Ethiopian government is considering fortification of iodized salt with folic acid, and possibly vitamin B, to address the high incidence of neural tube defects (NTDs) in Ethiopia. To prepare for this program, we assessed practices related to edible salt procurement and consumption, and the acceptability of novel salts fortified with iodine and folic acid (double-fortified salt, DFS) or iodine, folic acid, and vitamin B (triple-fortified salt, TFS) compared to iodized salt (IS). We surveyed 840 women of reproductive age in urban (Addis Ababa) and rural (Gimbichu Woreda) areas to describe their salt preferences and practices and used a three-point hedonic scale to evaluate the sensory acceptability of fine and coarse forms of DFS, TFS, and IS for color, taste, aroma, texture and overall acceptability.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!