iDecide: A Mobile Decision Support Tool Used for Adjuvant Therapy

iDecide：用于辅助治疗的移动决策支持工具

• 批准号: 8395179
• 负责人: Emily Meyers
• 金额: $ 20.24万
• 依托单位: EYES OF THE WORLD MEDIA GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-17 至 2013-06-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8395179
• 关键词: Address; Adherence; Adjuvant; Adjuvant Therapy; Adverse effects; Benefits and Risks; Cancer Etiology; Cancer Patient; Cancer Survivor; Cessation of life; Collaborations; Communication; Complex; Comprehensive Cancer Center; Computer software; Data; Decision Making; Development; Diagnostic Imaging; ERBB2 gene; Effectiveness; Electronic Health Record; Eye; Feasibility Studies; Feedback; Focus Groups; Health; Hormonal; Individual; Institution; Internet; Lead; Literature; Malignant Neoplasms; Marketing; Measures; Medical; Medical History; Methodology; Methods; Modeling; Molecular; Multimedia; National Cancer Institute; Needs Assessment; Oncologist; Operative Surgical Procedures; Pathology Report; Patient Preferences; Patients; Phase; Population; Postoperative Period; Prevention education; Price; Probability; Provider; Questionnaires; Radiation therapy; Records; Recurrence; Reporting; Research; Resource Development; Resource Sharing; Resources; Risk; Risk Reduction; Second Opinions; Surveys; Technology; Testing; Transcript; Translating; USC/Norris Comprehensive Cancer Center and Hospital; Update; Video Recording; Woman; Work; Writing; anticancer research; cancer recurrence; cancer surgery; chemotherapy; commercialization; empowered; evidence base; experience; health record; hormone therapy; improved; malignant breast neoplasm; mortality; product development; prototype; response; satisfaction; shared decision making; sound; technology development; tool; treatment adherence; treatment planning; tumor; usability

DESCRIPTION (provided by applicant): Breast cancer remains a leading cause of cancer deaths among women worldwide. Recurrence of cancer is 10-20% within 10 years after surgery and up to 60% or higher in patients with more aggressive cancers. Determining the best adjuvant therapy for an individual is daunting, complex, and often overwhelming, yet is of primary importance for shared decision making between patients and clinicians. To address this need, we will develop and test the feasibility of decide, a mobile decision support tool used in conjunction with adjuvant (postoperative) therapy decisions for breast cancer. decide will (1) use easy to understand multimedia to explain and quantify individualized probabilities of recurrence, mortality, and potential side effects of adjuvant therapies; (2) integrate newer molecular tests (e.g., Oncotype DX and MammaPrint) to refine risks of recurrence and benefit of chemotherapy and hormonal approaches; (3) allow patients to enter, upload, and share key health records (e.g., critical components of medical history, pathology reports and diagnostic imaging records) to facilitate second opinions; and (4) provide video vignettes conveying breast cancer survivors' experiences related to adjuvant therapy. Decide will be a valuable supplemental resource for patients and clinicians to weigh the individualized risks and benefits of adjuvant therapy and facilitate shared decision making. More informed decision making can lead to improved post-decision satisfaction and result in enhanced adherence and more efficient utilization of medical resources. Eyes of the World Media Group (EOW) will execute the project in collaboration with USC Norris Comprehensive Cancer Center. EOW has a successful track record producing health-centered mobile and web resources in partnership with research institutions. USC Norris is a major regional and national resource for cancer research, treatment, prevention, and education, and is designated by the National Cancer Institute as one of the nation's 40 comprehensive cancer centers. In this Phase I proposal, EOW aims to 1) conduct formative research through an online needs assessment with patients and providers to inform the development of the product; 2) develop a working prototype that contains decision support software, chemotherapy related info graphics, and a 1-3 minute video vignette; and 3) conduct a feasibility study. Qualitative and quantitative methods will assess the satisfaction, usefulness, comprehensibility, and usability of such a mobile resource for shared decision making. The mixed methodology approach of this Phase I effort will provide rich, sound data that will inform development of the full featured mobile resource in Phase II. We hypothesize decide may prove a valuable resource for patients and clinicians in making personalized, informed, and evidence-based decisions related to adjuvant therapy for breast cancer. ! PUBLIC HEALTH RELEVANCE: This mobile decision support resource is intended to facilitate shared decision making for complex treatment decisions after breast cancer surgery. It will help patients better understand individualized probabilities of expected benefits and risks of adjuvant therapy facilitate communication, and integrate portable electronic health records for second opinions. Ultimately, more informed decisions on adjuvant therapy can lead to better decision satisfaction, which may improve resource utilization, treatment adherence, and long-term survival for breast cancer patients.

描述(申请人提供)：乳腺癌仍然是全球女性癌症死亡的主要原因。手术后10年内，癌症复发率为10%-20%，在更具侵袭性的癌症患者中，复发率高达60%或更高。确定最适合个人的辅助治疗是令人望而生畏的、复杂的，而且往往是压倒性的，但对于患者和临床医生之间的共同决策是首要的。为了满足这一需求，我们将开发和测试Decision的可行性，这是一种移动决策支持工具，与乳腺癌的辅助(术后)治疗决策结合使用。Decision将(1)使用易于理解的多媒体来解释和量化个性化的复发概率、死亡率和辅助治疗的潜在副作用；(2)整合较新的分子测试(例如Oncotype DX和MammaPrint)以改进复发风险以及化疗和激素方法的益处；(3)允许患者输入、上传和共享关键健康记录(例如病史、病理报告和诊断成像记录的关键组成部分)以便于发表第二意见；以及(4)提供视频片段，传达乳腺癌幸存者与辅助治疗相关的经验。Decision将为患者和临床医生提供宝贵的补充资源，以权衡辅助治疗的个性化风险和好处，并促进共同决策。更知情的决策可以提高决策后的满意度，并提高对医疗资源的依从性和更有效的利用。世界媒体集团(EOW)的眼睛将与南加州大学诺里斯综合癌症中心合作执行该项目。Eow与研究机构合作，制作以健康为中心的移动和网络资源，取得了成功的记录。南加州大学诺里斯分校是癌症研究、治疗、预防和教育的主要地区性和全国性资源，被国家癌症研究所指定为全国40个综合性癌症中心之一。在这个第一阶段的提案中，EOW的目标是1)通过与患者和提供者的在线需求评估进行形成性研究，为产品的开发提供信息；2)开发一个工作原型，其中包含决策支持软件、与化疗相关的信息图形和1-3分钟的视频片段；以及3)进行可行性研究。定性和定量方法将评估这种共享决策的移动资源的满意度、有用性、可理解性和可用性。这项第一阶段工作的混合方法学方法将提供丰富、可靠的数据，为第二阶段全功能移动资源的开发提供信息。我们假设Decision可能被证明是患者和临床医生在做出与乳腺癌辅助治疗相关的个性化、知情和基于证据的决定时的宝贵资源。好了！ 与公共健康相关：这一移动决策支持资源旨在促进乳腺癌手术后复杂治疗决策的共享决策。它将帮助患者更好地了解辅助治疗的预期收益和风险的个性化概率，促进沟通，并整合便携式电子健康记录以供第二意见。最终，更明智的辅助治疗决策可以带来更好的决策满意度，这可能会改善乳腺癌患者的资源利用、治疗依从性和长期生存。