Study Shows Interactive Tool Increases Patient Knowledge of Breast Cancer Treatment Options

The Cancer Surveillance and Outcomes Research Team at the University of Michigan Comprehensive Cancer Center recently developed an interactive online tool to help patients with breast cancer understand their treatment options more fully.

“Knowledge is a key component of decision making, and yet it’s consistently low even among patients who have received treatment. We need better tools to make these decisions more informed,” Sarah T. Hawley, PhD, MPH, professor of internal medicine at Michigan Medicine, said in a statement.

According to a new study published in the Journal of Clinical Oncology, when compared with a static informational website, patients who used the interactive tool had higher knowledge and felt more prepared to make a treatment decision.

The study included 537 patients with newly diagnosed early-stage breast cancer from multiple practices spread throughout 4 states. The participating patients were randomized to view a tailored, interactive tool called “iCanDecide,” or to view similar information on a static website. Participants were then surveyed about 5 weeks later (496 completed the survey), after making their treatment decision.

The results showed that 61% of patients who used the interactive online tool had a high knowledge of treatment options compared with 42% of patients who viewed the static material. When asked if they felt prepared to make a treatment decision, 50% of patients who used the interactive tool responded that they felt prepared, compared with 33% of patients that viewed the static material.

“Instead of throwing the information on the website and hoping patients would figure it out, we gave them the bullet point fact, asked a question to see if they understood, and then allowed them to drill down and look at more detailed information. They couldn’t just bounce around. They had to go through it in a linear fashion,” said Hawley.

The interactive tool also assessed patients’ values through a series of hypothetical scenarios. At the end of the assessment, each patient received a personalized bar graphic that showed how their preferences matched to treatments. For example, if they valued keeping their natural breast, the lumpectomy bar would be higher.

“The values clarification is important. If you don’t combine the knowledge and the values, you get people making values-based choices that may not be fully informed,” said Hawley.

The researchers plan to refine the tool further to enhance the timing of decision tools and assessing patient values.

References

Hawley ST, Li Y, An LC, et al. Improving breast cancer surgical treatment decision making: the iCanDecide randomized clinical trial. J Clin Oncol. doi: 10.1200/JCO.2017.74.8442. Published online ahead of print January 24, 2018.