Individualizing Decision Quality for Patients with Breast Cancer: A RCT of a Com

新诊断为乳腺癌的患者面临着一系列关于局部和局部的复杂决定。 系统治疗。目前，这些决策中有许多不符合高质量决策的定义， 被定义为既被通知（即，基于对治疗风险的准确理解， 利益）和偏好一致（即，符合患者的潜在偏好）。此外，委员会认为， 评估性测试的引入使得许多患者的这些决定变得更加复杂。有一个 需要提高乳腺癌患者局部和系统治疗决策的质量， 帮助患者理解评估性测试在决策过程中的作用。确保患者能够 有效地考虑这些决定，坚持他们的观点，并与他们的临床医生沟通是可能的 以提高他们的整体决策准备和满意度。项目3将侧重于第三支柱， 通过评估创新决策工具对局部和系统的影响， 为新诊断的乳腺癌患者制定治疗决策。创新的在线决策工具 CanSORT团队（R21 CA 129859）在过去两年中开发并测试了该产品。导频数据 表明，该工具对患者的知识和决策结果有积极的影响。的目标 项目3是评估这一工具的影响，在与我们的通信部门合作加强这一工具之后 和传播核心，关于局部和系统性乳腺癌的决策质量 治疗决策。我们将对444名新诊断的 浸润性早期乳腺癌患者，由两个SEER集水区的28-30名外科医生观察。 患者将随机查看我们的综合决策工具或“最先进”的现有网站。 主要结果将是关于局部和全身治疗的高质量决策率， 查看CanSORT工具与现有网站的患者。其他结局将包括患者 关于评估测试和决策审议程度的知识。本RCT的结果将是 与未来的乳腺癌患者做出这些决定以及他们的临床医生高度相关，

Patients newly diagnosed with breast cancer face a series of complex decisions regarding locoregional and systemic treatment. Currently many of these decisions do not meet the definition of a high quality decision, defined as one that is both informed (i.e., based on an accurate understanding of the treatment risks and benefits) and preference-concordant (i.e., consistent with the patients' underlying preferences). Moreover, the introduction of evaluative tests has made these decisions more complicated for many patients. There is a need to improve the quality of locoregional and systemic treatment decisions for breast cancer patients, and to help patients understand the role of evaluative tests in this decision process. Ensuring patients can deliberate effectively about these decisions, assert their views and communicate with their clinicians is likely to improve their overall decision preparedness and satisfaction. Project 3 will focus on the third pillar of individualized care by evaluating the impact of an innovative decision tool on locoregional and systemic therapy decision making for newly diagnosed breast cancer patients. The innovative online decision tool has been developed and tested over the past two years by the CanSORT team (R21 CA129859). Pilot data suggests that this tool has a positive impact on patient knowledge and decision outcomes. The goal of project 3 is to evaluate the impact of this tool, after it is enhanced in collaboration with our Communication and Dissemination Core, on the quality of decision making for locoregional and systemic breast cancer treatment decision making. We will conduct a randomized controlled trial (RCT) of 444 newly diagnosed patients with invasive early stage breast cancer, seen by 28-30 surgeons in two SEER catchment areas. Patients will be randomized to view our comprehensive decision tool or a "state of the art" existing website. The primary outcomes will be the rate of high quality decisions about locoregional and systemic therapy for patients viewing the CanSORT tool vs. the existing website. Additional outcomes will include patient knowledge about evaluative tests and the extent of decision deliberation. The results of this RCT will be highly relevant to future breast cancer patients making these decisions and to their clinicians,