Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

Japke F. Petersen, Adriana Berlanga, Martijn M. Stuiver, Olga Hamming-Vrieze, Frank Hoebers, Philippe Lambin, Michiel W. M. van den Brekel

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    Objective: Patients diagnosed with advanced larynx cancer face a decisional process in which they can choose between radiotherapy, chemoradiotherapy, or a total laryngectomy with adjuvant radiotherapy. Clinicians do not always agree on the best clinical treatment, making the decisional process for patients a complex problem. Methods: Guided by the International Patient Decision Aid (PDA) Standards, we followed three developmental phases for which we held semi-structured in-depth interviews with patients and physicians, thinking-out-loud sessions, and a study-specific questionnaire. Audio-recorded interviews were verbatim transcribed, thematically coded, and analyzed. Phase 1 consisted of an evaluation of the decisional needs and the regular counseling process; phase 2 tested the comprehensibility and usability of the PDA; and phase 3 beta tested the feasibility of the PDA. Results: Patients and doctors agreed on the need for development of a PDA. Major revisions were conducted after phase 1 to improve the readability and replace the majority of text with video animations. Patients and physicians considered the PDA to be a major improvement to the current counseling process. Conclusion: This study describes the development of a comprehensible and easy-to-use online patient decision aid for advanced larynx cancer, which was found satisfactory by patients and physicians (available on www.treatmentchoice.info). The outcome of the interviews underscores the need for better patient counseling. The feasibility and satisfaction among newly diagnosed patients as well as doctors will need to be proven. To this end, we started a multicenter trial evaluating the PDA in clinical practice (ClinicalTrials.gov Identifier: NCT03292341). Level of Evidence: NA Laryngoscope, 129:2733–2739, 2019.

    Original languageEnglish
    Pages (from-to)2733-2739
    Number of pages7
    JournalLaryngoscope
    Volume129
    Issue number12
    Early online date2019
    DOIs
    Publication statusPublished - 1 Dec 2019

    Cite this