The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study
Abstract Purpose Patients with advanced larynx cancer face challenging treatment decisions. To address this, we developed and tested a patient decision aid (PDA), aiming to reduce decisional conflict (DC), and enhance knowledge and perceived shared decision-making (SDM). Methods In this multicenter...
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BMC
2025-07-01
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| Series: | BMC Medical Informatics and Decision Making |
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| Online Access: | https://doi.org/10.1186/s12911-025-03080-x |
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| author | Anne N. Heirman Japke F. Petersen Abrahim Al-Mamgani Simone E. J. Eerenstein Bertram J. de Kleijn Frank Hoebers Bernard M. Tijink Lisette van der Molen Gyorgy B. Halmos Richard Dirven Martijn M. Stuiver Michiel W. M. van den Brekel |
| author_facet | Anne N. Heirman Japke F. Petersen Abrahim Al-Mamgani Simone E. J. Eerenstein Bertram J. de Kleijn Frank Hoebers Bernard M. Tijink Lisette van der Molen Gyorgy B. Halmos Richard Dirven Martijn M. Stuiver Michiel W. M. van den Brekel |
| author_sort | Anne N. Heirman |
| collection | DOAJ |
| description | Abstract Purpose Patients with advanced larynx cancer face challenging treatment decisions. To address this, we developed and tested a patient decision aid (PDA), aiming to reduce decisional conflict (DC), and enhance knowledge and perceived shared decision-making (SDM). Methods In this multicenter study (ClinicalTrials.gov ID: NCT03292341, 2016–2023), a pre/post study design was used. Participants, meeting the inclusion criteria of advanced larynx cancer without distant metastasis, completed questionnaires on knowledge, DC and SDM immediately after counseling (T1) and 6 months post-treatment (T2). The intervention arm utilized the PDA (see https://beslissamen.nl/pda_launch.html?pda=tools/pda_larynx_en/story.html ) before completing T1 questionnaires, while the usual care arm followed standard procedures. Between-group differences in outcomes were estimated using regression models with correction for case mix differences. Results Total DC score was significantly lower in the intervention arm (n = 46) compared to the usual care arm (n = 45) (adjusted mean difference − 32, 95% CI: -37.4; -26.1, p < 0.001). The intervention group demonstrated significantly higher overall knowledge (mean 69% correct) than the control group (mean 47% correct)(adjusted mean difference 24, 95% CI 15.3; 33.1, p < 0.001). Almost all patients in usual care (44/45, 98%) experienced clinically significant DC (CSDC, DCS > 25), compared to 89% (41/46) in the intervention arm (adjusted OR 0.25, 95%CI 0.01; 1.9) p = 0.238). Perceived SDM was significant higher in the intervention arm (mean 78.16) compared to the usual care arm (mean 70.32); however, both groups exhibited high levels. Conclusion The PDA for advanced laryngeal cancer effectively reduced decisional conflict, enhanced patients’ knowledge and improved perceived SDM. Trial registration ClinicalTrials.gov ID NCT03292341, 20,151,231. Level of evidence 3. |
| format | Article |
| id | doaj-art-e719d23eb0034d9e960b79fd92001b7e |
| institution | Kabale University |
| issn | 1472-6947 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Medical Informatics and Decision Making |
| spelling | doaj-art-e719d23eb0034d9e960b79fd92001b7e2025-08-20T03:38:18ZengBMCBMC Medical Informatics and Decision Making1472-69472025-07-0125111010.1186/s12911-025-03080-xThe impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter studyAnne N. Heirman0Japke F. Petersen1Abrahim Al-Mamgani2Simone E. J. Eerenstein3Bertram J. de Kleijn4Frank Hoebers5Bernard M. Tijink6Lisette van der Molen7Gyorgy B. Halmos8Richard Dirven9Martijn M. Stuiver10Michiel W. M. van den Brekel11Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekDepartment of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekDepartment of Radiation Oncology, Cancer Institute – Antoni van LeeuwenhoekDepartment of Otolaryngology/Head and Neck Surgery, Amsterdam University Medical CenterDepartment of Otorhinolaryngology/Head and Neck Surgery, Radboud University Medical CenterDepartment of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical CentreDepartment of Head and Neck Surgical Oncology, University Medical Center UtrechtDepartment of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekDepartment of Otolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center GroningenDepartment of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekDepartment of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekDepartment of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute – Antoni van LeeuwenhoekAbstract Purpose Patients with advanced larynx cancer face challenging treatment decisions. To address this, we developed and tested a patient decision aid (PDA), aiming to reduce decisional conflict (DC), and enhance knowledge and perceived shared decision-making (SDM). Methods In this multicenter study (ClinicalTrials.gov ID: NCT03292341, 2016–2023), a pre/post study design was used. Participants, meeting the inclusion criteria of advanced larynx cancer without distant metastasis, completed questionnaires on knowledge, DC and SDM immediately after counseling (T1) and 6 months post-treatment (T2). The intervention arm utilized the PDA (see https://beslissamen.nl/pda_launch.html?pda=tools/pda_larynx_en/story.html ) before completing T1 questionnaires, while the usual care arm followed standard procedures. Between-group differences in outcomes were estimated using regression models with correction for case mix differences. Results Total DC score was significantly lower in the intervention arm (n = 46) compared to the usual care arm (n = 45) (adjusted mean difference − 32, 95% CI: -37.4; -26.1, p < 0.001). The intervention group demonstrated significantly higher overall knowledge (mean 69% correct) than the control group (mean 47% correct)(adjusted mean difference 24, 95% CI 15.3; 33.1, p < 0.001). Almost all patients in usual care (44/45, 98%) experienced clinically significant DC (CSDC, DCS > 25), compared to 89% (41/46) in the intervention arm (adjusted OR 0.25, 95%CI 0.01; 1.9) p = 0.238). Perceived SDM was significant higher in the intervention arm (mean 78.16) compared to the usual care arm (mean 70.32); however, both groups exhibited high levels. Conclusion The PDA for advanced laryngeal cancer effectively reduced decisional conflict, enhanced patients’ knowledge and improved perceived SDM. Trial registration ClinicalTrials.gov ID NCT03292341, 20,151,231. Level of evidence 3.https://doi.org/10.1186/s12911-025-03080-xPatient decision aidLarynx cancerCounselingShared decision-makingLaryngectomy |
| spellingShingle | Anne N. Heirman Japke F. Petersen Abrahim Al-Mamgani Simone E. J. Eerenstein Bertram J. de Kleijn Frank Hoebers Bernard M. Tijink Lisette van der Molen Gyorgy B. Halmos Richard Dirven Martijn M. Stuiver Michiel W. M. van den Brekel The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study BMC Medical Informatics and Decision Making Patient decision aid Larynx cancer Counseling Shared decision-making Laryngectomy |
| title | The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study |
| title_full | The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study |
| title_fullStr | The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study |
| title_full_unstemmed | The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study |
| title_short | The impact of a patient decision aid for patients with advanced laryngeal carcinoma – a multicenter study |
| title_sort | impact of a patient decision aid for patients with advanced laryngeal carcinoma a multicenter study |
| topic | Patient decision aid Larynx cancer Counseling Shared decision-making Laryngectomy |
| url | https://doi.org/10.1186/s12911-025-03080-x |
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