Decision aids for localized prostate cancer treatment choice: Systematic review and meta-analysis

Philippe D. Violette, Thomas Agoritsas, Paul Alexander, Jarno Riikonen, Henrikki Santti, Arnav Agarwal, Neera Bhatnagar, Philipp Dahm, Victor Manuel Montori, Gordon H. Guyatt, Kari A O Tikkinen

Research output: Contribution to journalArticle

60 Scopus citations

Abstract

Patients who are diagnosed with localized prostate cancer need to make critical treatment decisions that are sensitive to their values and preferences. The role of decision aids in facilitating these decisions is unknown. The authors conducted a systematic review of randomized trials of decision aids for localized prostate cancer. Teams of 2 reviewers independently identified, selected, and abstracted data from 14 eligible trials (n=3377 men), of which 10 were conducted in North America. Of these, 11 trials compared decision aids with usual care, and 3 trials compared decision aids with other decision aids. Two trials suggested a modest positive impact on decisional regret. Results across studies varied widely for decisional conflict (4 studies), satisfaction with decision (2 studies), and knowledge (2 studies). No impact on treatment choices was observed (6 studies). In conclusion, scant evidence at high risk of bias suggests the variable impact of existing decision aids on a limited set of decisional processes and outcomes. Because current decision aids provide information but do not directly facilitate shared decision making, subsequent efforts would benefit from user-centered design of decision aids that promote shared decision making.

Original languageEnglish (US)
Pages (from-to)239-251
Number of pages13
JournalCA Cancer Journal for Clinicians
Volume65
Issue number3
DOIs
StatePublished - May 1 2015

Keywords

  • decision making
  • decision support techniques
  • patient education as topic
  • patient participation
  • patient preference
  • patient satisfaction
  • prostatic neoplasms

ASJC Scopus subject areas

  • Oncology
  • Hematology

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    Violette, P. D., Agoritsas, T., Alexander, P., Riikonen, J., Santti, H., Agarwal, A., Bhatnagar, N., Dahm, P., Montori, V. M., Guyatt, G. H., & Tikkinen, K. A. O. (2015). Decision aids for localized prostate cancer treatment choice: Systematic review and meta-analysis. CA Cancer Journal for Clinicians, 65(3), 239-251. https://doi.org/10.3322/caac.21272