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Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial.
Cancer 2015; 121(20):3717-26C

Abstract

BACKGROUND

Patient decision aids (P-DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow-up from a thyroid cancer treatment P-DA trial.

METHODS

In this single-center, parallel-design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early-stage thyroid cancer patients from a P-DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P-DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P-DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, and physician trust. In a subgroup of 20 participants, in-depth interviews were conducted for a qualitative analysis.

RESULTS

Ninety-five percent (70 of 74) of the original population enrolled in follow-up at a mean of 17.1 months after randomization. P-DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer-related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P-DA was perceived to have increased patient knowledge and confidence in decision making.

CONCLUSIONS

The P-DA improved cancer survivors' actual and long-term perceived medical knowledge with no adverse effects. More research on the long-term outcomes of P-DA use is needed.

Authors+Show Affiliations

Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada.Department of Medicine, St. Michael's Hospital/University of Toronto, Toronto, Canada.Department of Psychosocial Oncology, University Health Network/University of Toronto, Toronto, Canada.Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada.Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada.Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada.Department of Surgery, University Health Network/University of Toronto, Toronto, Canada.Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada.Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada.Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.Dalla Lana School of Public Health, University of Toronto/Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.Department of Otolaryngology and Head and Neck Surgery, University Health Network/University of Toronto, Toronto, Canada.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26195199

Citation

Sawka, Anna M., et al. "Thyroid Cancer Patient Perceptions of Radioactive Iodine Treatment Choice: Follow-up From a Decision-aid Randomized Trial." Cancer, vol. 121, no. 20, 2015, pp. 3717-26.
Sawka AM, Straus S, Rodin G, et al. Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial. Cancer. 2015;121(20):3717-26.
Sawka, A. M., Straus, S., Rodin, G., Heus, L., Brierley, J. D., Tsang, R. W., ... Goldstein, D. P. (2015). Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial. Cancer, 121(20), pp. 3717-26. doi:10.1002/cncr.29548.
Sawka AM, et al. Thyroid Cancer Patient Perceptions of Radioactive Iodine Treatment Choice: Follow-up From a Decision-aid Randomized Trial. Cancer. 2015 Oct 15;121(20):3717-26. PubMed PMID: 26195199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial. AU - Sawka,Anna M, AU - Straus,Sharon, AU - Rodin,Gary, AU - Heus,Lineke, AU - Brierley,James D, AU - Tsang,Richard W, AU - Rotstein,Lorne, AU - Ezzat,Shereen, AU - Segal,Phillip, AU - Gafni,Amiram, AU - Thorpe,Kevin E, AU - Goldstein,David P, Y1 - 2015/07/20/ PY - 2015/03/25/received PY - 2015/06/01/revised PY - 2015/06/04/accepted PY - 2015/7/22/entrez PY - 2015/7/22/pubmed PY - 2016/1/7/medline KW - decision aids KW - decision making KW - decision support techniques KW - iodine radioisotopes KW - patient satisfaction KW - qualitative research KW - thyroid cancer SP - 3717 EP - 26 JF - Cancer JO - Cancer VL - 121 IS - 20 N2 - BACKGROUND: Patient decision aids (P-DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow-up from a thyroid cancer treatment P-DA trial. METHODS: In this single-center, parallel-design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early-stage thyroid cancer patients from a P-DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P-DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P-DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, and physician trust. In a subgroup of 20 participants, in-depth interviews were conducted for a qualitative analysis. RESULTS: Ninety-five percent (70 of 74) of the original population enrolled in follow-up at a mean of 17.1 months after randomization. P-DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer-related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P-DA was perceived to have increased patient knowledge and confidence in decision making. CONCLUSIONS: The P-DA improved cancer survivors' actual and long-term perceived medical knowledge with no adverse effects. More research on the long-term outcomes of P-DA use is needed. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/26195199/Thyroid_cancer_patient_perceptions_of_radioactive_iodine_treatment_choice:_Follow_up_from_a_decision_aid_randomized_trial_ L2 - https://doi.org/10.1002/cncr.29548 DB - PRIME DP - Unbound Medicine ER -